Major Diagnostic Breakthrough in Multiple Sclerosis Achieved

[NZer1]

Nigel Wadham
https://www.facebook.com/pages/CCSVI-in ... 1636357984

http://www.thisisms.com/forum/post177580.html#p177580
Thanks Dr. Flanagan for the link ;)

Major Diagnostic Breakthrough in Multiple Sclerosis Achieved with Advanced FONAR UPRIGHT® MRI -- MEL
http://www.prnewswire.com/news-releases ... 15283.html
www.prnewswire.com
Major Diagnostic Breakthrough in Multiple Sclerosis Achieved with Advanced FONAR UPRIGHT® MRI.
Major Diagnostic Breakthrough in Multiple Sclerosis Achieved with Advanced FONAR UPRIGHT® MRI




MELVILLE, N.Y., Oct. 5, 2011 /PRNewswire/ -- In a newly published paper, medical researchers at FONAR Corporation (NASDAQ-FONR) report a diagnostic breakthrough in multiple sclerosis (MS), based on observations made possible by the company's unique FONAR UPRIGHT® Multi-Position™ MRI. The findings reveal that the cause of multiple sclerosis may be biomechanical and related to earlier trauma to the neck, which can result in obstruction of the flow of cerebrospinal fluid (CSF), which is produced and stored in the central anatomic structures of the brain known as the ventricles. Since the ventricles produce a large volume of CSF each day (500 cc), the obstruction can result in a build up of pressure within the ventricles, resulting in leakage of the CSF into the surrounding brain tissue. This leakage could be responsible for generating the brain lesions of multiple sclerosis.
The paper, titled "The Possible Role of Cranio-Cervical Trauma and Abnormal CSF Hydrodynamics in the Genesis of Multiple Sclerosis," has just been published and appears in the latest issue of the journal Physiological Chemistry and Physics and Medical NMR (Sept. 20, 2011, 41: 1-17). It is co-authored by MRI researchers Raymond V. Damadian and David Chu.
Commenting on the study, the lead researcher and president of FONAR, Raymond V. Damadian stated, "These new observations have uncovered biomechanical barriers that appear to give rise to multiple sclerosis, and, even more excitingly, these barriers may be therapeutically addressable." Damadian is the medical doctor who discovered the abnormal signals from tissue that are the basis of every MRI image made today and who went on to invent the MRI and build the world's first MRI by hand at New York's Downstate Medical Center.
The findings are based on viewing the real-time flow of cerebrospinal fluid in a series of eight randomly chosen patients with multiple sclerosis.
The cerebrospinal fluid, known as CSF, lubricates the brain and spinal cord. Utilizing FONAR's patented Advanced UPRIGHT® Multi-Position™ MRI technology, the team was able to view the flow of cerebrospinal fluid in and out of the brain with the patients lying down and upright. These invaluable dual observations have only been possible since the invention of an MRI capable of imaging the patient upright.
Damadian and co-researcher, Chu, discovered obstructions of the CSF flow in all eight patients in the study and, in seven out of eight patients, the obstruction was more pronounced when the patient was in the upright position. The UPRIGHT® MRI also revealed that these obstructions were the result of structural deformities of the cervical spine, induced by trauma earlier in life.
The research was initiated when Damadian and Chu scanned a patient with multiple sclerosis. In reviewing the MRI scans, Damadian noted that one of the MS lesions in the patient's brain was directly connected with the CSF within the ventricles of the brain, which are the structures in which the body continuously produces CSF fluid. It does so through a network of blood vessels within the ventricles known as the choroid plexus. This network generates a large volume of CSF daily, approximately 500 cc.
Damadian knew that in multiple sclerosis the lesions are typically concentrated adjacent to the ventricles and are peri-ventricular in distribution (i.e. surrounding the ventricle). He had also determined that the patient had a history of severe trauma to the cervical spine. When a careful history of subsequent patients in the study was taken, it revealed that all but one had also experienced some form of serious traumatic injury to the cervical spine.
When viewing MRI scans of the first patient, Damadian hypothesized that any obstructions of the continuous circulation of the daily volume of CSF out of the brain to the spinal cord and back could cause increased pressure within the ventricles, which could result in leakage of the fluid into the brain tissue surrounding the ventricles.
Damadian knew that CSF fluid contains proteins, which are made up of polypeptides, in fact, that the fluid contains more than 300 polypeptides. Nine of the proteins they form are known to be antigens that stimulate the production of antibodies. He wondered if these proteins, leaking into the brain tissue, could be initiating the antigen-antibody complexes in the brain that cause the pathology and symptoms of multiple sclerosis.
The disease results in the destruction of the coverings, or myelin sheaths, that insulate the nerve fibers of the brain. The destruction prevents the nerves from functioning normally and produces the symptoms of multiple sclerosis. The destruction is the origin of the multiple sclerosis lesions seen on the MRI images.
But, unlike nerve tissue, the myelin sheaths can regenerate – once the cause of their destruction is eliminated. The paper suggests that surgical or biomechanical remediation of the obstruction of the flow of CSF in the cervical spine could relieve the increased CSF pressure within the ventricles and eliminate the resultant leakage of fluid into the surrounding brain tissue and the inflammation of the myelin sheaths that it generates. Once the leakage has been stopped, the myelin sheaths could be repaired by the body's myelogenesis process with the prospect of a return to normal nerve function for these nerves.
Images in the recumbent and upright positions of one of the MS patients from the study follow. Note the presence of ventral CSF flow when the patient (MS patient #6) is recumbent (Figure 6c) but the loss of ventral CSF flow when the patient is upright (Figures 6b).
To see more examples and images visit www.fonar.com/news/100511.htm.
See the attached photo of a patient in the FONAR UPRIGHT® Multi-Position™ MRI. Unlike traditional lie-down MRIs, patients walk into the UPRIGHT™ MRI and sit in the scanner. In the diagnosis of usual spine problems such as back pain, the patients are asked to place themselves in the position that causes their back symptoms. Then an upright MRI image is generated. As a result, the spinal pathology that is causing the patient's back pain can be more accurately and more completely identified and defined. Since the seat in the MRI can be tilted to any position and also flattened into a bed in the horizontal position, the researchers were able to view the patients in the MS study in both the recumbent and upright positions.
The study was part of ongoing research at the UPRIGHT® MRI CENTER at FONAR Corporation, which invented the UPRIGHT® MRI scanner. Research at the center, which is located in Melville, New York, has already provided unique diagnostic views of the upright spine with the weight of the body on it, including the spine with the patient bending forward and backward, radiation-free monitoring of scoliosis, upright imaging of pelvic floor problems in women, such as a prolapsed bladder or uterus, sit-down imaging of the prostate without the usual endorectal coil, and a walk-in, sit-down 10-minute scan that allows for cost-effective MRI scanning of patients undergoing chemotherapy to monitor tumor responses biweekly.
The complete study that led to the diagnostic breakthrough in multiple sclerosis can be accessed at the company website at www.fonar.com/pdf/PCP41_damadian.pdf
To see the full release and additional images visit www.fonar.com/news/100511.htm
About the Researchers
Raymond V. Damadian is the medical doctor who first proposed scanning medical patients by NMR (nuclear magnetic resonance, the original name of the MRI) based on his discovery of the principle on which all modern MRI is based – the different NMR signals that tissues emit in a magnetic field. The amplitude of these signals accounts for the pixel brightness in every MRI image. He discovered that the NMR signal amplitudes of cancer tissue differ markedly from the NMR signal amplitudes of the normal tissues because of the differences in their rate of decay. He simultaneously discovered that the NMR signal amplitudes also differ markedly among the normal tissues themselves because of the differences in their rates of decay. These signal amplitude differences enabled cancer tissues and other tissues to be visualized in MRI images because the signal differences generate the needed brightness differences (contrast) in the picture elements (pixels) needed to visualize detail in the MRI image. The contrast in pixel brightness allows the cancer pixels in the image to be distinguished from the surrounding normal pixels. It also allows the different normal tissues to be distinguished from each other and achieve the exceptional anatomic detail MRI pictures are known for. Damadian went on to build the first MRI scanner by hand, assisted by two post-doctoral students, at New York's Downstate Medical Center and achieved the first MRI scan of a healthy human body in 1977 and a human body with cancer in 1978. For these discoveries he received the National Medal of Technology from President Reagan in 1988, was inducted into the National Inventors Hall of Fame in 1989 as the inventor of the MRI and was named Inventor of the Year in 2007 for his invention of the FONAR UPRIGHT® Multi-Position™ MRI. He founded FONAR to bring MRI diagnosis to patients. The company manufactured and installed the world's first commercial MRI in 1980. Damadian is currently FONAR's president and chief research officer.
David Chu is the head MRI scientist at FONAR who specializes in the imaging of the cerebrospinal fluid with advanced cines, or movies, which allow for observation of CSF flow in real time. The technology, which the company calls TrueFlow™ Imaging, made the diagnostic breakthrough in multiple sclerosis possible.

[1eye]

Perivenous, periplaque, periventricular, Perry Como, Perry Mason, OK, already. Looks like a reasonable study. I'm going to read it. If I find out I have hydrocephalus due to an injury, what can be done?

[ikulo]

I have many herniated discs, from the S-spine L-lumbar and C-Spine. But not sure what can be done about them even if they are implicated in MS.

[NZer1]

"The research was initiated when Damadian and Chu scanned a patient with multiple sclerosis. In reviewing the MRI scans, Damadian noted that one of the MS lesions in the patient's brain was directly connected with the CSF within the ventricles of the brain, which are the structures in which the body continuously produces CSF fluid. It does so through a network of blood vessels within the ventricles known as the choroid plexus. This network generates a large volume of CSF daily, approximately 500 cc."

From memory the CSF is pumped because of he pulsing of an artery that crosses the CSF sac in the neck. So the action of pulsing would also be affected if there is slow blood flow through the brain which is also noted in PwMS. The studies have also shown that PwMS have a larger volume of blood within the brain than normal's and that is not at higher BP, it is blood that is taking up space that CSF would normally have, as well as atrophy of the brain also seen in PwMS.

[David1949]

I have many herniated discs, from the S-spine L-lumbar and C-Spine. But not sure what can be done about them even if they are implicated in MS.

I also have MS and a herniated disc. ( Don't remember the disc number but it's the lowest one). One month worth of physical therapy fixed the pain and other problems associated with the herniated disc. But I still wonder if the drop foot and weakness in my left leg might be due to the disc and not MS.

[cheerleader]

The advent of the upright MRI will be very helpful. I have bulging disc disease, and have had bone spurs at C4-5...but I don't have MS. Jeff's neck is fine, looks great, but he had malformed jugular veins.
Injury may very well be part of someone's MS, but you can have CSF build up with CCSVI, as well. Dr. Eliot Frohman was the one who first said the normal pressure hydrocephalus reminded him of what Dr. Zamboni was discussing in CCSVI....and he placed shunts to remove excess CSF.
Here's my post on this from '09--
http://www.thisisms.com/forum/chronic-c ... c8147.html

Dr. Eliot Frohman, professor of neurology at Southwestern University- was a moderator and participant in the CCSVI convocation. He consistently had cogent and insightful questions and comments during the day. One of his points has stayed with me, and prompted me to do some more research on cerebrospinal fluid. Dr. Frohman commented that CCSVI was reminding him of his shunting treatment of normal pressure hydrocephalus ...mainly in the fact that the third ventricle was being enlarged in both MS and NPH- Here's his comment-
Quote:
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.

Here's NPH-
Quote:
The brain and spinal cord are surrounded by a clear fluid called cerebrospinal fluid (CSF). This fluid is produced and stored in cavities in the brain called ventricles. It circulates around the brain, moving from ventricle to ventricle. The purposes of the fluid are to cushion and protect the brain and spinal cord, to supply them with nutrients, and to remove some of their waste products. Any excess fluid drains away from the brain and is absorbed by other tissues.

Hydrocephalus is a condition in which there is too much CSF in the ventricles. This occurs when the natural system for draining and absorbing extra CSF does not work right. The ventricles enlarge to accommodate the extra fluid and then press on different parts of the brain, causing a number of different symptoms. Hydrocephalus has many different causes. Some people are born with the condition, while others develop it during their lives.

Normal pressure hydrocephalus (NPH) is a type of hydrocephalus that occurs in adults, usually older adults. The average age of people with NPH is older than 60 years. NPH is different than other types of hydrocephalus in that it develops slowly over time. The drainage of CSF is blocked gradually, and the excess fluid builds up slowly. The slow enlargement of the ventricles means that the fluid pressure in the brain may not be as high as in other types of hydrocephalus. However, the enlarged ventricles still press on the brain and can cause symptoms. (The term "normal pressure" is somewhat misleading.)

We know that hydrocephalus can occur due to jugular stenosis or blockage. This is well documented in Crouzon's and jugular foramen stenosis....but the hydrocephalus is REALLY apparent. In normal pressure hydrocephalus, it takes longer to cause damage, because it is a slower process. So...I took it from here to look in to why some more progressive folks might be having restenosis after stenting...PERHAPS the CSF excess pressure is not relieved enough by merely opening the jugulars, restenosis can form. I have sent the following research to Dr. Dake-
http://www.ajnr.org/cgi/content/full/28/4/656

Quote:
By definition, in secondary intracranial hypertension (SIH), there is an underlying medical condition, whereas in IIH, the cause is not known. In many cases of SIH, an increased cerebral venous pressure raises the intracranial pressure as in dural venous fistulas, venous sinus thrombosis, or venous sinus compression.1 However, in almost all patients with IIH (and also in our patients), neuroimaging shows narrowing of the transverse sinuses,2,3,5–7 not reflecting acute thrombosis. The important question is whether those venous abnormalities are cause or consequence of increased intracranial pressure. In the former situation, fixed stenoses (for example postthrombotic fibrotic changes) could obstruct the venous outflow, increase intracranial venous pressure proximal to the stenosis, and lead to increased CSF pressure as a result of a reduction in CSF absorption via the arachnoid granulations. In this setting, a pressure gradient across the stenosis should be measured and reconstruction of the venous lumen with endovascular stents would be effective in lowering elevated CSF pressure. This procedure was successfully used several times4,6 but seems not to be efficient in all patients.6 In the latter (ie, venous abnormalities as a consequence of intracranial pressure), elevated intracranial CSF pressure could lead to a secondary narrowing of the sinus lumen by compression, which can be reversed by lumbar puncture or shunt surgery procedures.5,7,8 In fixed stenoses (the 1st model), therapeutic reduction of CSF pressure should have no effect on sinus diameter.


If you're still following me here...this is the thought....maybe in most individuals (like my Jeff), it is the stenosis causing the CSF level changes, and resolving the stenosis takes care of it....BUT maybe in some folks, like our dear skydog....it is the CSF levels causing the stenosis, and relieving the stenosis in one place only creates restenosis somewhere else, because the CSF issue is not resolved.

We'll see what Dr. D says on this, or if my thinking is wrong. THIS IS WHY WE NEED NEUROS WORKING WITH VASCULAR DOCS TOGETHER...
cheer

[MrSuccess]

Great news. Now let's get this fantastic Upright MRI into the hands of Dr.Hubbard.

There has been a long held belief that Trama ..... has caused MS in previously healthy people . This is based on statistics . Two separate studies revealed that 5% and 7% of injured people go on to be diagnosed , as having MS.

5% and 7% of the general population DO NOT HAVE MS.

Interestingly enough , Dr.Dake has reported a vast majority of stenosis are found near the CI of the spine. This is next to the Atlas. This is where whiplash trauma often occurs.

Dr.Zamboni's discovery has solved this puzzle.

And more good news. The inventor of this MRI seems confident that his invention can lead
to a solution of MS .

I agree .


Mr.Success

[MarkW]

I suggest a test of this upright MRI before and after a gold standard CCSVI syndrome diagnosis and de-stenosis by Dr Sclafani. Brooklyn and Melvile are pretty close, so its just a matter of money and people talking.
We may be at the start of showing what CCSVI treatment does to CSF flow in the brain.

MarkW

[Cece]

Trauma may aggravate MS or be a promoting factor in the timing of onset of MS but I suspect it lacks the specificity and sensitivity to be an outright cause of MS. Trauma also affects neurons directly, through axon shearing, that would be particularly bad in someone with underlying MS. CCSVI predicts abnormalities in CSF flow. This study found such abnormalities but it also found direct obstructions causing them. I am glad that there is such technology as the upright MRI and that there are researchers looking outside the original explanation of MS as autoimmune. A larger controlled study looking at CSF in patients with MS would be great. How accurate do we think the technology is at showing CSF flow? I know MRVs have gotten some slack in CCSVI as not being as accurate.

[se1956]

This is very interisting.

So the autoimmune response could be the inheritable co-morbidity (typically in RRMS), that is trigged by some biomechanical disorder from CSF flow and/or CCSVI.

Trauma alone can not explain the inheritable part.

R.

[bestadmom]

This study is the precursor to the chiropractic studies in Albany, NY being done w/Damadian. MRI pre and post AO adjustment show the blocked csf flow being restored. There's a lesion component to this as well, with mri showing lesions disappearing (not overnight).

My gut says MS is a catch all diagnosis which includes genetics/ccsvi as the underlying factor, and external/environmental factors including but not limited to neck and head trauma pushing the disease to activate. The incedence of MS in vets is higher than in the average population. The military is studying this currently.

[HappyPoet]

In July of this year, I participated in a randomized, double-blinded study in Albany, NY, (see bestadmom's post above) of 41 patients that my Atlas Orthogonal (AO) chiro, Dr. Craig Wehrenberg, Dr. Scott Rosa, and a radiologist M.D. are doing that measures, via US, blood flow velocity through the carotids and jugulars, and measures, via upright MRI, CSF flow before and after AO upper cervical chiro (UCC) adjustment.

Immediately after my adjustment (not sham arm), a notable increase in CSF flow was measured.

AO chiro is the only intervention that has ever helped my numb feet and MS Hug. With AO chiro, the numbness in my feet receded 100%, and the spasticity in my torso muscles (MS Hug) receded 75%.

I suggest that people read Dr. Flanagan's (uprightdoc) thread CCSVI and CCVBP. He'll answer questions and help find UCC doctors.

EDIT: Another similar study planned for 2012 by the same doctors of an MS-only cohort is in the design stages, and my AO chiro, Dr. Wehrenberg, is starting to informally recruit patients. I (and several others from TIMS) am on the list for this study.

[THEGREEKFROMTHED]

I THINK THE WHOLE THING SUCKS AND NOW I AM JUST MORE CONFUSED AS TO WHY IM SO F%^&*# UP!
also why do stem cells help? why does tysabri help someone> why does chemo help someone? why does nothing help someone? I agree with bestadmom theres a zillion things going on in us..Come to think of it though i did have an annualr tear at c4-5 but thats pretty low and not even a few years later started with this BS of MS, but in 4 years went to a wehelchair? Almost all the guys my age here at work had accidents or other guys walking around with chicken bones holding their spine together after surgeries and they dont have MS or its BS. WTF? next theory please.

[David1949]

Well it sounds promising but wake me up when they say "YES! we can cure all MS NOW!!"

[THEGREEKFROMTHED]

take Don at work here for instance. 46 Hes built like a cross between arnold and adonnis. He fell of his garage when he was 6 and snapped three vertebrae in his neck. He runs marathons, has muscle popping from all extremeities, plays intramural basketball and soccer. When he was 16 totalled his car and has some nasty back damage. you wouldnt know...if his cns is leaking its not doing jack shit or at least not now!!