Multiple sclerosis and CCSVI: a critical review

[Cece]

www.brgeneral.org/uploads/CCSVI20and20MS.pdf

Multiple sclerosis and chronic cerebrospinal venous insufficiency: a critical review

Amer M Awad, Ellen Marder, Ron Milo, and Olaf Stuve
Therapeutic Advances in Neurological Disorders published online 10 May 2011

Conclusion

Based on conflicting published data, it is currently unclear whether CCSVI exists as a pathologic entity, or as an anatomic variant in patients with MS. It is even less substantiated that there is a causal association between CCSVI and MS.

Based on a review of the literature, it is our view that the concept of CCSVI is inconsistent with the epidemiology, pathology, and many of the clinical features of MS. Pending further investigations, no therapeutic interventions involving treatment of plausible CCSVI should be recommended for patients outsie of controlled clinical settings.

It's interesting, from my own experience and my knowledge of the MS literature, CCSVI is consistent with the epidemiology, pathology, and many of the clinical features of MS. That last one especially. There has been much unexplained by the autoimmune theory that the CCSVI theory explains.

[ikulo]

Most of their comments note that it's unclear how CCSVI could cause MS, and so they conclude that it can't. example: "Geographical variations in MS prevalence cannot be explained by CCSVI theory." erm..... why not? If they actually disproved some of these elements it'd be one thing, but just concluding that it can't possibly make sense is so lazy.

[Cece]

Couldn't agree more, ikulo.

For the geographical variations in MS prevalence, we've got both the effects of heat/sunshine/vitamin D on the vasculature...and I was going to say that chronic venous insufficiency (varicose veins) had a geographical prevalence too but now I think that's the one that has a greater predominance of female sufferers, as does MS.

[1eye]

Probably I'm just dense, but I can't think of an internal mammalian feature more likely to be influenced by the prevailing temperature than vasculature. Amount of fat, maybe?

[EJC]

Sometimes we can't see the wood for the trees.

Don't get me wrong, I like the theory of CCSVI and it has helped my partner and has certainly slowed down the number and ferocity her replapses if we compare year on year as well as providing signifcant improvements in her eyesight.

However, I think there's a long long way to go before we all start shouting Eureka.

I feel reading "conclusions" of this nature are actually a step in the right direction, we've moved away from the "it's all complete hogwash" to "it's currently unclear and requires more research".

Seems like a very reasonable conclusion to me.

Those of us that choose or already have had CCSVI treatment, it's undertaken knowing it is experimental and currently in it's infancy.

Look at a statement of this nature as glass half full, not half empty. After all it's right - we need far more research for CCSVI to progress and be understood.

[frodo]

Based on conflicting published data, it is currently unclear whether CCSVI exists as a pathologic entity, or as an anatomic variant in patients with MS.

I really like this sentence. If CCSVI is not a pathologic entity, at least it is an anatomic variant. So much for the people that denies its existence.

It is sad to be discussing still the existence of CCSVI but every once in a while somebody appears claiming that CCSVI does not exists.

[1eye]

I think we will soon see conclusive, unequivocal proof of the pathological effects of venous outflow problems on the animal CNS. The thing about an animal experiment is it can be run as many times as you can breed the animals, and the proof can be recorded in real time electronically, and replayed at will. The 100% figure is also associated with other natural phenomena, like the percentage of time the Earth rotates around the sun, and the percentage of time the common cold is caused by a virus. It may be that in an animal model the experimenter will be able to induce (and perhaps remove) CCSVI-like (or other diseases' ) symptoms and pathology.

The determination of the prevalence and genetics of CCSVI are perhaps another means of discriminating against the genetically inferior. That kind of thing seems to be getting quite common these days.

[Lyon]

..

[EJC]

Based on conflicting published data, it is currently unclear whether CCSVI exists as a pathologic entity, or as an anatomic variant in patients with MS.

I really like this sentence. If CCSVI is not a pathologic entity, at least it is an anatomic variant. So much for the people that denies its existence.

I got the idea that they intended that to mean that it's unclear whether CCSVI exists at all, either as a disease or anatomic variant in patients with MS?

Conclusion
Based on conflicting published data, it is currently unclear whether CCSVI exists as a pathologic entity, or as an anatomic variant in patients with MS. It is even less substantiated that there is a causal association between CCSVI and MS.

You've read that wrong, it's the connection that is unclear, the existence of the theory of connection is what is being questioned, not the theory of the existance of CCSVI.