Canadian Journal of Neurological Sciences

[PCakes]

Check this out..

The Canadian Journal of Neurological Sciences
Issue: Volume 37, Number 6 / November 2010
Pages: 745 - 756
URL: Linking Options

Multiple Sclerosis - A Vascular Etiology?


Bryce Weir A1

A1 Department of Surgery, University of Chicago, Illinois, USA


Abstract:

From the earliest pathological studies the perivenular localization of the demyelination in multiple sclerosis (MS) has been observed. It has recently been suggested that obstructions to venous flow or inadequate venous valves in the great veins in the neck, thorax and abdomen can cause damaging backflow into the cerebral and spinal cord circulations. Paolo Zamboni and colleagues have demonstrated abnormal venous circulation in some multiple sclerosis patients using non-invasive sonography and invasive venography. Furthermore, they have obtained apparent clinical improvement or stabilization by endovascular ballooning of points of obstruction in the great veins in some, at least temporarily. If non-invasive observations by others validate their initial observations of a significantly increased prevalence of venous obstructions in MS then trials of angioplasty/stenting would be justified in selected cases in view of the biological plausibility of the concept.


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[PointsNorth]

thanks Janet!

I've done a search for the full article but turned up nothing. Would you have a link?

Best, PN

[1eye]

Check this out..

The Canadian Journal of Neurological Sciences
Issue: Volume 37, Number 6 / November 2010
Pages: 745 - 756
URL: Linking Options

Multiple Sclerosis - A Vascular Etiology?


Bryce Weir A1

A1 Department of Surgery, University of Chicago, Illinois, USA


Abstract:

From the earliest pathological studies the perivenular localization of the demyelination in multiple sclerosis (MS) has been observed. It has recently been suggested that obstructions to venous flow or inadequate venous valves in the great veins in the neck, thorax and abdomen can cause damaging backflow into the cerebral and spinal cord circulations. Paolo Zamboni and colleagues have demonstrated abnormal venous circulation in some multiple sclerosis patients using non-invasive sonography and invasive venography. Furthermore, they have obtained apparent clinical improvement or stabilization by endovascular ballooning of points of obstruction in the great veins in some, at least temporarily. If non-invasive observations by others validate their initial observations of a significantly increased prevalence of venous obstructions in MS then trials of angioplasty/stenting would be justified in selected cases in view of the biological plausibility of the concept.


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I've only read the abstract, but what bothers me is the same old dependence on the non-conclusive screening test to justify the conclusive x-ray venogram. My own opinion is that the trumped-up need for something less 'invasive' than x-ray venography, or thinking that Doppler Ultrasound can be used to determine prevalence of CCSVI in 'MS' in any conclusive way is misleading, and more foot-dragging. 'Selected cases' -- certainly we know who it is that will do the selection.

Doppler is a test to determine who does not need venography. The likelihood, IMO, is, if you have been told you have 'MS' you probably don't need Doppler. But please: let your GP and the vascular doctor or Radiologist figure it out.

The first I heard that I had 'MS' was not from neurologists or even the eye specialist who had sent me for an MRI (it was conclusive for 'MS' but not important enough for him to tell me about it), but from the Radiologist who did the next MRI. Guess he was tired of seeing me chase my tail.

[ozarkcanoer]

Hi Pcakes !!! Thanks for this ! It is good to see some open minds about CCSVI.

ozarkcanoer

[Cece]

Great find Pcakes!!! I like it because it's CCSVI friendly, in a neurology journal, and has the statement that it would only take a significantly increased prevalence in CCSVI in MSers means that the bar is not at the 100% mark. Even the Buffalo numbers qualify as significantly increased as does the recent one with 92% (?) prevalence of CCSVI in advanced cases of MS.

[PCakes]

Hi all,

I like the positive lean of this one, too. and in a Neuro Journal..!!

Dr Bryce Weir..Looks like he has retired. He has quite the portfolio including some neurovascular history in his honoured and honourable career.
I'd like to read the whole article so will spend the $ later. If I can, I'll share.

On a note, ..this, from the same volume..

The Canadian Journal of Neurological Sciences
Issue: Volume 37, Number 6 / November 2010
Pages: 716 - 716
URL: Linking Options

CCSVI: Hope, Hype or Snake Oil?


Joel Oger A1 and Mona Alkhajawah A1

A1 University of British Columbia, Vancouver, British Columbia, Canada


This article does not have an abstract.

Don't think I'll 'buy' that one..

Hey Points North.. sorry, no Janets here..

1eye..please don't stress.

[Shayk]

Cece

Even the Buffalo numbers qualify as significantly increased as does the recent one with 92% (?) prevalence of CCSVI in advanced cases of MS.

If you're speaking of the study from Lebanon, I think it's important to note that "advanced MS" in that study (LMS--late MS in the abstract) is RRMS. So, in fact they found 92% prevalence of CCSVI in RRMS per the abstract.

From that abstract:

late MS (LMS): RRMS of more than 10 years duration.

Unfortunately they didn't give any EDSS scores for that cohort.

Onward all....

Sharon

[Cece]

Thanks, Shayk.

[PCakes]

The body of the 'MS - A Vascular Etiology' article contains detailed info on cerebrospinal blood flow, imaging and comparitive neurovascular issues.. the following is the conclusion..

The possibility that venous reflux, reversal of flow, andvenous hypertension are the primary inciting causes of at least some forms of MS is currently a defensible hypothesis. In varying forms this is not a new idea having some rationale from pathological studies. It remains to be seen if independent investigators, using larger numbers of patients, will replicate the strength of the association between MS and initially,sonographic abnormalities and if positive, subsequently,pathology on venography. Assuming this occurs and is also supportive, finally, interventional procedures in selected patients, enrolled in organized trials with randomization,appropriate controls, blinded assessment techniques, with indicated monitoring and sufficient follow-up time, would be appropriate. Will the operative relief of sites of flow obstruction provide durable remission? Will the procedures prove safe? Until what point in the course of the disease is it reasonable to anticipate a cessation of progression even if the theory is true? The huge community of sufferers, perhaps millions world-wide, for better or worse, already has had its hopes raised by a blizzardof one-sided reporting in the popular press and the internet on the “Liberation Procedure” so there is some urgency.

The abstract was a bit misleading. But who am I?...

[MrSuccess]

this is all good news. I see nothing wrong with the second article -apart from the title - as we all want to see every possible aspect of CCSVI acid tested .

Bottom line ...... the ball is rolling ...... and in the Neuro's end .




Mr. Success