Patients with MS had a significant decrease of cerebrovascular reactivity compared with controls. This decrease in CRV correlated to gray matter atrophy, but did not correlate with white matter lesions.
Conclusions. Abnormally low CVR in MS patients appeared to be restored following IFN beta treatment. As CVR is a component of neurovascular coupling relevant for preserved tissue physiology and integrity, this study suggests that altered CVR may affect brain functional responses and development of damage in MS. The effect of immunomodulation on CVR in patients suggests that altered CVR is related to inflammation and supports further investigations on the use of regional CVR as a potential early marker of therapeutic effect.
Results: A significant decrease of mean (SD) global gray matter CVR was found in patients with MS (3.56 [0.81]) compared with healthy controls (5.08 [1.56]; P = .001). Voxel-by-voxel analysis showed diffuse reduction of CVR in multiple regions of patients with MS. There was a significant negative correlation between gray matter CVR and lesion volume (R = 0.6, P = .004) and a significant positive correlation between global gray matter CVR and gray matter atrophy index (R = 0.5, P = .03).
Conclusions and Relevance: Our quantitative imaging findings suggest impairment in functional cerebrovascular pathophysiology, by measuring a diffuse decrease in CVR, which may be the underlying cause of neurodegeneration in MS.
It is quite possible that venous stasis, or slowed cerebral drainage, could be responsible for the number of viruses (such as EBV and HHV) and bacteria (such as Cpn and Lyme) that have been associated with MS-by allowing these infectious agents to pass through the blood brain barrier. Here is the Buffalo review on this topic:
The association between EBV infection and CCSVI has not yet been explored; however, it could be hypothesized that venous stasis in the superior saggital sinus due to extracranial outflow impairment could affect the drainage of bridging veins that pass through the subarachnoid space (near the meninges and EBV-infected B-cell follicles) and contribute to EBV activation. The venous stasis hypothesis in the SSS may contribute to understanding why so many different viruses and bacteria [3,111] have been linked to increased MS susceptibility risk over the last 50 years.
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