MS as Normal Pressure Hydrocephalus (NPH) new research

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cheerleader
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MS as Normal Pressure Hydrocephalus (NPH) new research

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The dominant hypothesis in multiple sclerosis is that it is an autoimmune disease; however, there is considerable evidence that the immune attack on myelin may be secondary to a cytodegenerative event. Furthermore, the immune modulating therapies longest in clinical use, although modulating the frequency and severity of exacerbation, do not affect long-term progression towards disability. Clearly alternative perspectives on the etiology of multiple sclerosis are warranted. In this paper I outline the commonalities between idiopathic normal pressure hydrocephalus and multiple sclerosis. These include decreased intracranial compliance as evidenced by increased cerebrospinal fluid volume and velocity of cerebrospinal fluid flow through the cerebral aqueduct; increased ventricular volume; periventricular demyelination lesions; increase in size of Virchow-Robin spaces; presence of Hakim’s triad comprised of locomotory disabilities, cognitive problems and bladder control problems. Furthermore, multiple sclerosis is associated with decreased arterial compliance. These are all suggestive that there is a pulse wave encephalopathy component to multiple sclerosis. There are enough resemblances between normal pressure hydrocephalus and multiple sclerosis to warrant further investigation. Whether decreases in intracranial compliance is a consequence of multiple sclerosis or is a causal factor is unknown. Effective therapies can only be developed when the etiology of the disease is understood. - See more at: http://www.eurekaselect.com/129386/arti ... 0a8Zv.dpuf
http://www.eurekaselect.com/129386/article


From Dr. Bernhard Juurlink--basic science.
If cerebrospinal fluid builds up in the brain, damage and demyelination occurs.
MS looks an awful lot like normal pressure hydrocephalus.
I first learned about NPH from Dr. Elliot Frohman in Bologna, Italy--at the first CCSVI conference in September 2009. It was Dr. Frohman, an MS specialist and neurologist, who commented that CCSVI treatment reminded him of the success he had seen after treating his patients for NPH. Here is what Dr. Frohman said about venoplasty for CCSVI. I wrote it down in my notes, because his comment literally stunned me.

"I have seen this happen in “normal pressure hydrocephalus- (NPH) Where there is a loss of gait, cognitive and bladder issues and the lesions disappear because the expanded ventricle swallows the lesion. I have shunted the brains of NPH patients, and they showed remarkable improvements. Again, the enlargement of the third ventricle precedes the changes."
http://ccsviinms.blogspot.com/2012/11/n ... -once.html

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David1949
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Re: MS as Normal Pressure Hydrocephalus (NPH) new research

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Does NPH produce lesions on the brain and spinal cord that resemble MS lesions? Also does it cause antibodies to be present in the CSF?
If so what, tests are done to determine whether the patient has MS or NPH?
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Re: MS as Normal Pressure Hydrocephalus (NPH) new research

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David1949 wrote:Does NPH produce lesions on the brain and spinal cord that resemble MS lesions? Also does it cause antibodies to be present in the CSF?
If so what, tests are done to determine whether the patient has MS or NPH?
Yes, David--NPH does produce demyelinating lesions on the brain which resemble MS lesions.
They are called "periventricular lesions"--found alongside the ventricles, which carry CSF.
Here's more on this from Dr. Juurlink.
http://www.msdiscovery.org/forums/discu ... -pathology

Like MS, elevated immunoreactive myelin basic protein is found in CSF in NPH
Immunoreactive myelin basic protein (MBP) levels were measured in cerebrospinal fluid (CSF) samples taken from 57 patients with active hydrocephalus (age range 3 weeks to 60 years). Of these patients, 28 (49%) had elevated MBP values (greater than 4.5 ng/ml). Elevated MBP levels were found in 44% of patients with congenital hydrocephalus, 75% of patients with posttraumatic hydrocephalus, 80% of patients with normal-pressure hydrocephalus, and 83% of patients with porencephaly.
http://www.ncbi.nlm.nih.gov/pubmed/6193255

The enlarged third ventricle is also a common finding in both NPH and MS.
Here's more on the demyelination found in NPH.
http://www.ncbi.nlm.nih.gov/pubmed/12027829
http://www.ncbi.nlm.nih.gov/pubmed/10864607
http://www.ajnr.org/content/22/9/1665.full

Typically, age, gait imbalance, bladder and cognitive function are the factors in determining NPH. MS is considered a "young person's disease." But it sure shares a lot with NPH. There are no tests, per se. Just opinions. Thus the 100+ differentials for MS.
Some lesions in hypertensive elderly patients, however, are periventricular and are quite similar to multiple sclerosis lesions. Lacunes are common in the basal ganglia, but not in the corpus callosum. Vascular lesions with aging tend to be smaller and random but sometimes symmetrically involve the periventricular white matter in confluent posterior ischemic damage (Arnold and Matthews 2002).
http://www.medmerits.com/index.php/arti ... lerosis/P8

The sad thing is, people with MS have been sold a bill of goods. MS is not unique. We see the same myelin basic protein antibodies in the CSF of stroke patients, traumatic brain injury, hydrocephalus and in others with diseases of white matter. But no MS specialist wants to talk about that.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466349/
http://www.discoverymedicine.com/Yi-Zha ... em-injury/
http://stroke.ahajournals.org/content/4 ... 1/S75.full

Here's my blog post from 2010 on the "autoimmune" response in stroke. http://ccsviinms.blogspot.com/2010/12/t ... troke.html
Ask your neuro....and live a heart healthy life.
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Re: MS as Normal Pressure Hydrocephalus (NPH) new research

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So, here we have a human analogue to MS which can be studied by vascular specialists and neurologists together.
Yet neurology continues to cling to the EAE model of MS---which is not MS in humans. At all.
70 years since Thomas Rivers EAE model, and all we have to show for it is a 20 billion dollar a year drug industry.
No MS etiology.
criminal.
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Re: MS as Normal Pressure Hydrocephalus (NPH) new research

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Let's see if I understand this. From what i'm reading NPH can produce the same markers as MS i.e. lesions on the brain and spinal column, as well as antibodies ( Igg ?) in the CSF. NPH also causes the symptoms I have; loss of gait, and bladder issues.
Also I read somewhere that NPH comes on gradually. That is also what I have experienced with PPMS. The big difference is that PPMS problems cannot be improved by the mainstream medical community, but NPH can be improved by a shunt which allows csf to leave the brain. Is that correct?
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Re: MS as Normal Pressure Hydrocephalus (NPH) new research

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Yes, David. Correct on all points.
Shunts are placed in some, not all cases of NPH, and do provide relief for many.

However, we already have research that shows that venoplasty to correct CCSVI improved CSF flow in 15 patients with MS.
It was phase 1 of the Buffalo blinded study...but sadly, this part of the study didn't get any press. So, you probably didn't hear about it.

Changes of cine cerebrospinal fluid dynamics in patients with multiple sclerosis treated with percutaneous transluminal angioplasty: a case-control study.
http://www.ncbi.nlm.nih.gov/pubmed/23523158

Lots more info coming out of ISNVD this weekend. More researchers getting involved from more countries. Main speaker was from Amsterdam University, on heart-brain connection. We're getting there.
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Re: MS as Normal Pressure Hydrocephalus (NPH) new research

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Increasing speed of CSF flow in normal pressure hydrocephalus reduces cognitive fog, improves bladder issues.
“I was the most frustrated person in the world because at no time did a doctor give us a real diagnosis,” said Mr. Ferguson’s wife, Elva. The suspicions of Mr. Ferguson’s daughter eventually led to an accurate diagnosis through an M.R.I. and neurological tests. The Fergusons also found Dr. Jeffrey Chen, the director of neurotrauma for the Legacy Health System in Portland, Ore., who is skilled at treating this often-reversible condition.

Two days after surgery to install a programmable shunt that relieved the pressure on the frontal lobes of his brain, Mr. Ferguson walked across a room for the first time in a year. He was able to think and write clearly, and his incontinence improved.
http://www.nytimes.com/2009/05/26/healt ... .html?_r=0


And CSF flow is altered and slowed by venous stenosis.
http://www.ncbi.nlm.nih.gov/pubmed/20018140

From the ISNVD conference last weekend--- my write up.
Blood storage within the intracranial space and its impact on cerebrospinal fluid dynamics
Clive B Beggs 1, Simon J Shepherd 1, Pietro Cecconi 2 and Maria Marcella Lagana 2Medical Biophysics Laboratory, University of Bradford, Bradford, BD7 1DP, UK Fondazione Don Carlo Gnocchi ONLUS, IRCCS S. Maria Nascente. Milan, Italy
This study measured blood flow throughout the cardiac cycle by using MRI to visualize the flow in the necks of 14 healthy adults. This study found that it is cerebrospinal fluid (CSF) which controls the volume changes inside the brain. CSF interacts with the cortical veins to facilitate how much blood is stored. This is an important finding, because any disturbance in venous outflow of blood and CSF will change the blood storage inside the skull, potentially leading to reduced cerebral circulation.
http://ccsviinms.blogspot.com/2015/03/2 ... racts.html

Here are all of the abstracts and presentations from ISNVD 2015.
Highly recommended reading.
http://isnvd.org/d/sites/default/files/ ... %20all.pdf
Husband dx RRMS 3/07
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Re: MS as Normal Pressure Hydrocephalus (NPH) new research

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There are many viruses and bacterial infections associated with MS, which have been found in brain tissue. Yet no one single virus or bacteria has ever been isolated. This is because when the blood brain barrier is injured, brain tissue is susceptible to many different plasmic particles. Some camps claim it's EBV, others look for retroviruses, others look to the bacteria Cpn. And others claim it's iron deposition into brain tissue. But not one has been isolated. All have been linked to MS.

Venous stasis is the theory which unites the viral, bacterial and iron deposition theories with the hypoperfusion scientifically seen in the MS brain. Because a permeable blood brain barrier allows access to any plasmic particle.

More from BNAC on venous stasis.
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.
http://www.expert-reviews.com/doi/abs/1 ... ern.11.117
http://ccsviinms.blogspot.com/2011/08/b ... d-ebv.html

It's not going to be one particular plasmic particle----it's the fact that the blood brain barrier is permeable, and brain tissue is hypoxic.
Look at the dilated ventricles and breach in the BBB.
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Last edited by cheerleader on Thu Apr 02, 2015 7:45 am, edited 1 time in total.
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Re: MS as Normal Pressure Hydrocephalus (NPH) new research

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David---
this study is for you. 8O


Here is a study where two MS patients were found to also have normal pressure hydrocephalus---dilated ventricles is the shared marker. They were treated with CSF shunts and "significantly improved."
Here we report 2 chronic MS patients who had progressive dementia, gait disturbance and urinary incontinence and in whom neuroimaging, and in one case CSF infusion studies, suggested hydrocephalus. Both significantly improved following shunting procedures. We suggest that further study is required to investigate whether a significant proportion of patients with chronic MS and dilated ventricles have shunt-responsive hydrocephalus.
http://www.ncbi.nlm.nih.gov/pubmed/7712624


cheer
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