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BNAC study shows CCSVI not in all MSer's or cause

Posted: Wed Apr 13, 2011 2:17 pm
by eric593
How disappointing.

http://www.buffalo.edu/news/12469

Really stresses the importance of replicated findings and not simply going with the first results of a small unblinded study.

Posted: Wed Apr 13, 2011 2:30 pm
by jackiejay
this is being triumphantly plastered all over the news in Canada tonight.....Jock Murray and Barry Rubin were beside themselves with glee...at least I'm assuming they are pleased...

Posted: Wed Apr 13, 2011 2:43 pm
by WeWillBeatMS
After reading the news release I don't understand how the figures can possibly lead the researchers to conclude that CCSVI may be a result of MS but not a cause of it. I see it more like CCSVI could be causing some other neurological disorders in addition to MS. I don't care if it's the chicken or egg though, I want it fixed. I wish there were other more natural ways to correct it other than "surgery" but right now it's all we have.

WeWillBeatMS

Posted: Wed Apr 13, 2011 3:00 pm
by ikulo
isn't this the study from last year?

Posted: Wed Apr 13, 2011 3:00 pm
by jimmylegs
?? is it this one? edit: no wait wrong journal..

http://www.ajnr.org/cgi/content/abstract/ajnr.A2386v1
American Journal of Neuroradiology
HEAD & NECK
Value of MR Venography for Detection of Internal Jugular Vein Anomalies in Multiple Sclerosis: A Pilot Longitudinal Study

BACKGROUND AND PURPOSE: CCSVI was recently described in patients with MS. CCSVI is diagnosed noninvasively by Doppler sonography and invasively by catheter venography. We assessed the role of conventional MRV for the detection of IJV anomalies in patients with MS diagnosed with CCSVI and in healthy controls who underwent MRV and Doppler sonography examinations during 6 months.

MATERIALS AND METHODS: Ten patients with MS underwent TOF, TRICKS, Doppler sonography, and catheter venography at baseline. They were treated at baseline with percutaneous angioplasty and re-evaluated 6 months' posttreatment with MRV and Doppler sonography. In addition, 6 healthy controls underwent a baseline and a 6-month follow-up evaluation by Doppler sonography and MRV.

RESULTS: At baseline, the sensitivity, specificity, PPV, and NPV of Doppler sonography for detecting IJV abnormalities relative to catheter venography in patients with MS were calculated, respectively, at 82%, 100%, 99%, and 95%. The figures were 99%, 33%, 33%, 99% for TOF and 99%, 39%, 35%, and 99% for TRICKS. Venous anomalies included the annulus, septum, membrane, and malformed valve. No agreement was found between TOF and catheter venography in 70% of patients with MS and between TRICKS and catheter venography in 60% of patients with MS. At follow-up, 50% of the patients with MS presented with abnormalities on Doppler sonography but only 30% were diagnosed with restenosis.

CONCLUSIONS: Conventional MRV has limited value for assessing IJV anomalies for both diagnostic and posttreatment purposes.

Posted: Wed Apr 13, 2011 3:04 pm
by 1eye
Really stresses the importance of replicated findings and not simply going with the first results of a small unblinded study.
I don't understand what you are saying. I think the most that can be said is that where attempts have been made to form conclusions, things remain inconclusive. A non-existent disease without causes cannot be a cause of a disease of genetics, no matter what statistics you drum up.

Once hypoxia and hypoglycemia have combined with the genetics causing CCSVI a cycle of degradation takes place of which 'MS' is an unfortunate side-effect. The proof is in the treatment.

Posted: Wed Apr 13, 2011 3:04 pm
by jackiejay
why is it always bad news coming from Zivadinov and friends?...

Posted: Wed Apr 13, 2011 3:09 pm
by jimmylegs
ok got it

Prevalence, sensitivity, and specificity of chronic cerebrospinal venous insufficiency in MS

ABSTRACT
Background: Chronic cerebrospinal venous insufficiency (CCSVI) was recently described in patients with multiple sclerosis (MS). A subject is considered CCSVI positive if 2 venous hemodynamic (VH) criteria are fulfilled.

Objective: To determine prevalence of CCSVI in a large cohort of patients with MS, clinically isolated syndrome (CIS), other neurologic diseases (OND), and healthy controls (HC), using specific proposed echo-color Doppler (ECD) criteria.

Methods: Transcranial and extracranial ECD were carried out in 499 enrolled subjects (289 MS, 163 HC, 26 OND, 21 CIS). Prevalence rates for CCSVI were calculated in 3 ways: first, using only the subjects for whom diagnosis was certain (i.e., borderline subjects were excluded); secondly, including the borderline subjects in the “no CCSVI” group; and finally, taking into account subjects who presented any of the VH criteria.

Results: CCSVI prevalence with borderline cases included in the “no CCSVI” group was 56.1% in MS, 42.3% in OND, 38.1% in CIS, and 22.7% in HC (p 0.001). The CCSVI prevalence figures were 62.5% for MS, 45.8% for OND, 42.1% for CIS, and 25.5% for HC when borderline cases were excluded (p 0.001). The prevalence of one or more positive VH criteria was the highest in MS (81.3%), followed by CIS (76.2%), OND (65.4%), and HC (55.2%) (p 0.001). CCSVI prevalence was higher in patients with progressive than in nonprogressive MS (p 0.004).

Conclusions: Our findings are consistent with an increased prevalence of CCSVI in MS but with modest sensitivity/specificity. Our findings point against CCSVI having a primary causative role in the development of MS.

Posted: Wed Apr 13, 2011 3:22 pm
by eric593
I don't understand a stitch of what you've said, 1eye. Are you still on a starvation protest?

What I'm saying is that this puts into question Dr. Zamboni's findings when such a large blinded study couldn't duplicate the prevalence of CCSVI. And it casts doubt on the theory of a congenital nature to CCSVI when so many MSer's didn't have CCSVI early on and the prevalence grows the more severe the illness.

This is how science works: a hypothesis is put forth, it is tested, and subsequent studies attempt to replicate the earlier findings. These results do not support Dr. Zamboni's research. As Joan has said, future research will elucidate CCSVI's role in MS, and this research casts doubt on Dr. Zamboni's hypothesis and study.

What it doesn't tell us is whether treating CCSVI alleviates any part of MS pathogenesis or symptoms or whether a higher rate of CCSVI is found in MSer's versus controls on venogram. Hopefully subsequent research will elucidate that.

Posted: Wed Apr 13, 2011 3:29 pm
by jimmylegs
i think it's interesting how the percentage of people found to have CCSVI increases along a spectrum from healthy controls, to clinically isolated syndrome, to other neuro disorders, to MS.

Posted: Wed Apr 13, 2011 3:39 pm
by MrSuccess
.... and on April 7th 2011 ... the BNAC published some interesting
results ...... and one week later ..... April 13th 2011 .... we are given this..

Anyone care to explain ?

Bottom Line : Mr. Success neither cares if the chicken or the egg came first .... what concerns Mr. Success is the long or short term concern that so-called healthy controls .... are at possible risk .... to develop MS.

I have said this before .... time and time again..... it is monstrous to have knowledge that these people have indications of abnormal [ in appearance ] veins ........ and take no preventive action .....

The question is not appearance ...... it is FLOW.

Professor Zamboni has said as much.

Did the BNAC report FLOW or just vein appearance ?




Mr. Success

Posted: Wed Apr 13, 2011 3:40 pm
by jackiejay
I thought most of the other studies coming out lately have shown that the percentage of pwMS having CCSVI was around 90+ percent.....what gives?

Posted: Wed Apr 13, 2011 3:57 pm
by muse
“…The results of the UB study are based on 499 participants in the Combined Transcranial and Extracranial Venous Doppler Evaluation (CTEVD) study, which began at the university in April 2009 [/i] :!: Release Date: April 13, 2011 :!: Source: http://www.buffalo.edu/news/12469

“…Concludes Zivadinov: "The differences between our study, the original Italian CCSVI study and other recently published studies also emphasize the need for a multimodal approach for the assessment of CCSVI. In addition to Doppler sonography, use of selective venography, magnetic resonance VENOGRAPHY AND intraluminal DOPPLER methods can provide more evidence :!: for the true prevalence of CCSVI in MS…." Source: http://www.buffalo.edu/news/12469

Those numbers are just the interim results of the DOPPLER EVALUATION (CTEVD) study, from 2009! At this stage there wasn’t any venography done either which is the gold standard to diagnose CCSVI :!:

Please read the notes by Joan/cheer:

and the latest paper done by Zivadinov/BNAC as well.

http://www.ajnr.org/cgi/reprint/ajnr.A2 ... e=HWCIT&ct

Posted: Wed Apr 13, 2011 4:10 pm
by jimmylegs
am i missing something? i don't see anything inconsistent in starting research in 2009 and releasing some findings in 2011

Posted: Wed Apr 13, 2011 4:21 pm
by eric593
jackiejay wrote:I thought most of the other studies coming out lately have shown that the percentage of pwMS having CCSVI was around 90+ percent.....what gives?
Those were venogram results. The problem is you can't blind a venogram study unless healthy people are willing to undergo a venogram in the name of science.

I wonder if venograms would even be permitted on MSer's who have not already met the criteria for CCSVI on doppler/MRV beforehand to see if they actually have CCSVI on venogram in spite of not demonstrating it on the noninvasive diagnostic tests.