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Robert Zivadinov, MD, PhD, says new research may reveal how extracranial venous abnormalities contribute to various diseases as well as aging.
UB Researchers Urge Broad Study of Venous Abnormalities
Published February 27, 2014

Although their oft-cited prior study found no causal relationship between venous abnormalities in the neck and multiple sclerosis (MS), University at Buffalo neurological researchers are strongly advocating more investigation.

“We have developed a substantial body of work looking at these abnormalities in relation to Alzheimer’s disease, aging and other neurological diseases.”
Robert Zivadinov, MD, PhD
Professor of neurology
Related Profile
Robert Zivadinov, MD, PhD Related Articles
Potential Involvement of the Extracranial Venous System in Central Nervous System Disorders and Aging (BMC Medicine, Dec. 17, 2013)
Is There a Link Between the Extracranial Venous System and Central Nervous System Pathology? (BMC Medicine, Dec. 17, 2013)
New Study on MS and CCSVI (April 13, 2011) Related Links
2/19/14 Department of Neurology Share This
Print Robert Zivadinov, MD, PhD, professor of neurology, and his colleagues cite mounting evidence that the extracranial venous system may play a role in a broad range of central nervous system disorders and aging.

“The full story and consequence of these venous abnormalities that disrupt normal blood flow will require much more research,” says Zivadinov, who also directs UB’s Buffalo Neuroimaging Analysis Center.

New Research Could Explore Risk Factors
Countering calls to abandon related research, Zivadinov has coauthored a debate article, “Potential Involvement of the Extracranial Venous System in Central Nervous System Disorders and Aging,” with Chih-Ping Chung, MD, PhD, of National Yang-Ming University in Taiwan, in BMC Medicine.

Zivadinov also published a related editorial, “Is There a Link Between the Extracranial Venous System and Central Nervous System Pathology?” in the same journal.


He and Chung call for research examining the incidence and prevalence of venous abnormalities in relation to developmental and demographic factors, as well as cardiovascular, inflammatory and lifestyle risk factors.

Prior ‘Neurology’ Study Among Most Cited
In their July 2011 study, “Prevalence, Sensitivity and Specificity of Chronic Cerebrospinal Venous Insufficiency in MS,” published in Neurology, Zivadinov’s team found an increased prevalence of extracranial venous abnormalities in MS patients, but no evidence of causation.

Their paper is one of the top 10 articles in neurology and the second-most-cited paper in neurology in the past three years, according to Neuropenews, the news blog of the European Federation of Neurological Societies and the European Neurological Society.

“We have since developed a substantial body of work looking at these abnormalities in relation to Alzheimer’s disease, aging and other neurological diseases,” says Zivadinov.

“We believe our current studies on how these abnormalities impact central nervous system pathology will also prove to be of ongoing interest to the scientific community.”

Abnormalities May Impede Blood Flow From Brain
Extracranial venous abnormalities indicate chronic cerebrospinal venous insufficiency (CCSVI), a condition characterized by the narrowing of vessels that drain blood from the cranium.

Paolo Zamboni of the University of Ferrara in Italy was the first to hypothesize that the condition results in changes in blood flow patterns that eventually injure brain tissue and degenerate neurons, leading or contributing to MS.

Compared to Zamboni’s research, the UB study found much lower sensitivity and specificity rates of CCSVI in MS patients.

However, the UB team did find a much higher prevalence of CCSVI in progressive versus non-progressive MS patients, suggesting the condition may be a consequence, rather than a cause, of MS.

The research team included Department of Neurology co-authors Ralph H. Benedict, PhD, professor; Michael G. Dwyer III, PhD, assistant professor; David W. Hojnacki, MD, assistant professor; Bianca Weinstock-Guttman, MD, professor; as well as Murali Ramanathan, PhD, professor of pharmaceutical sciences.

Thanks Blossom for posting this. I find it interesting that there is a higher prevalence of CCSVI in progressive MS "suggesting that the condition may be a consequence rather than a cause of MS", that is to say it isn't congenital. Thanks again, Vesta

Spoke to Dr. Zivadinov at ISNVD--the work he is doing with Dr. Chung and the Taiwanese team is important. But it feels like he is trying to "tell a story" about what CCSVI is and isn't---rather than letting the research develop.

Here is a new study that used the correct and complete Zamboni doppler protocol and found CCSVI in 453 pwMS (83%)--and notes that the patients younger than 30 had more severe stenosis than the older group. The researchers believe that the duration of the disease changes venous hemodynamics, and worsens cerebral vascular outflow. "It may be possible that early clinical, pharmacological and/or invasive vascular interventions could exert a possible role in the natural history of multiple sclerosis. Nevertheless, further trials are needed in order to confirm such considerations."
http://www.ncbi.nlm.nih.gov/pubmed/24274909

This study is showing the potential congenital connection to venous malformations and CCSVI.
The research is far from over, and I wish Dr. Zivadinov didn't feel he has to put his stamp on everything.
cheer

There is a saying in Germany I did grow up with - “Wer einmal lügt dem glaubt man nicht auch wenn er die Wahrheit spricht”. My grandmother always told me to remember this proverb in life, which would be in English “There is no believing a liar, even when he speaks the truth." She was a lovely woman filled with wisdom.
p.s. I’ve heard Dr. Z is going to do nutrition/Hormon-D “science” in near future as well. What a neuroland-multi-talent. [end of sarcasm]

Hello Muse: Where was your angio performed? Have the veins remaind open and what difference did the therapy make for you? Thanks, Vesta

I got a bilateral angioplasty of my VJ done in Wellington NZ two times (2010 & 2011) with brilliant results but after ~12-14 month
both veins restenosed again each time, Vesta. 2012 I’ve started with high dosages of Magnesium and I was able to reverse my second restenosis that way. I’m fine since than, which means I’m managing my CCSVI very well but I’m not cured. Here you can see my personal monthly tracking graphs: http://www.ccsvi-tracking.com/_partGraphics.php Best Arne

cheerleader wrote:The research is far from over, and I wish Dr. Zivadinov didn't feel he has to put his stamp on everything.

Interesting comment. I've learned in life that the "movers and shakers", those that we all have to thank for much in the way of progress, generally have big egos, and are not necessarily the kind of people we'd want to share a meal with.

But, that doesn't diminish their accomplishments.

Dr. Zivadinov has much respect in the neurological community (which I know is not shared by many on this forum), and I think may do much to advance CCSVI understanding.

However, the UB team did find a much higher prevalence of CCSVI in progressive versus non-progressive MS patients, suggesting the condition may be a consequence, rather than a cause, of MS.

This is a fairly large conclusion and as far as I can tell, there has not yet been enough data to draw this conclusion, especially with the difficulty there has been in determining which form of imaging is the most accurate.

It's hard for me, though, not to be excited about all our CCSVI researchers, Dr. Zivadinov included. He has funding and name recognition and he's partnering with the Taiwanese researchers, who are excellent.

muse wrote:I got a bilateral angioplasty of my VJ done in Wellington NZ two times (2010 & 2011) with brilliant results but after ~12-14 month
both veins restenosed again each time, Vesta. 2012 I’ve started with high dosages of Magnesium and I was able to reverse my second restenosis that way. I’m fine since than, which means I’m managing my CCSVI very well but I’m not cured. Here you can see my personal monthly tracking graphs: http://www.ccsvi-tracking.com/_partGraphics.php Best Arne

Hello muse: I can't access your link. Can you give me the date this was posted so I can find it? I find it fascinating that Magnesium could reverse a restenosis. Thanks, Vesta

Sorry Vesta, I can't because that are all graphics (no numbers etc.) and most likely you have to be registered with this website http://www.ccsvi-tracking.com to watch it. I forgot that those data are not public. Sorry again. Best Arne

When I first read about Zivadinov's original research proposal. I was excited because it was aimed at confirming Zamboni's results but with a much bigger sample but also because he seemed to be interested in examining the possible effects of CCSVI on other neurological conditions. I had thought simply that problems with drainage of the brain would be unlikely to be linked solely to MS. The whole idea of impaired drainage effecting other neurological conditions seemed eminently plausible.

Sadly that seemed to get lost in the final report which was a shame. I still think it is a good idea and potentially a very large area of investigation. So I am still pleased to see someone promoting the idea. But of course Zivadinov's reputation is a bit sullied. There were obvious and elementary errors of inference and false (unsupported) claims in his report (which were reported as the 'results' of the research in many journals) which appeared to be simply political bias. I still wonder whether these came from Zivadinov or Weinstock-Guttman. Weinstock-Guttman has since come out firmly against the existence of CCSVI so it seems quite possible she was the source. Nevertheless Zivadinov did put his name to the report.

Whenever I see videos of Robert I have always liked what he says about CCSVI and he appears to me to be sincere. What is contained in this position piece is also good. It clearly tries to be both impartial and comprehensive and states 'both' sides of the argument. So I find it difficult to dislike him. But would I trust him to lead large scale research about cranial heamodynamics and neuropathology? Well certainly not if he was teamed up with Weinstock-Guttman again but partnering with Chung maybe.

So I would say he has not rehabilitated himself yet but I do think he deserves our support in connection with this paper.

I must have missed the memo on Dr. Weinstock- Guttman. Since when has she taken the position that CCSVI does not exist ? As far as I am aware .... this fine doctor has always taken the scientific approach , in that she will let the science of CCSVI , prove or dispell the CCSVI > MS theory.

Seems like a logical thing to do , IMHO.

I have nothing but admiration for Dr. W-G.



MrSuccess

Sorry I have not replied sooner. I don't log-on very often nowadays. Bianca gave a talk at one of the big conferences either last year or the year before (I think ISNVD but I am not sure) where she seemed to me to say that she thought CCSVI was just normal variation. I did make a copy of the quote but I am afraid I have since lost it. I will keep looking and post it if I find it. Perhaps you have other quotes from her which say something different? I would be interested to hear. Sorry to be so vague. I am also now off for a two week holiday so I will try and post something when I return

as we now have such an large amount of CCSVI information to discuss and debate , there
are so few of us able to recall each and every comment on offer.

I do not think we need to save each and every comment , for future debate.

We are not running a court room here , so we can relax the rules and just discuss CCSVI and all people involved. Sometimes we are right ... sometimes not so much.

All in all , things are progressing exceptionally well in exploring the connection between MS and CCSVI.

All opinions are worthy of hearing . Including yours AMcG.


MrSuccess