ISNVD 2016-moving forward

[cheerleader]

ISNVD 2016 will be at the Academy of Sciences in New York City in April.
Keynote speaker will be Jonathan Kipnis---his lab discovered the brain's lymphatic vessels and immune system--which rely on veins for drainage.
Also, lots of international presentations on CCSVI clinical trials and registries.

This research is not quietly going away, it is growing in scope and influence, as more connections continue to be made between brain health, diseases of neurodegeneration, and the vasculature.

http://ccsviinms.blogspot.com/2015/12/m ... rward.html


cheer

[Cece]

Happening now!

[Cece]

http://isnvd.org/content/about-isnvd

About ISNVD

The purposes of the International Society for Neurovascular Disease (ISNVD) are:
•To promote communication, research, development, applications, and the availability of information on neurovascular and related neurodegenerative diseases such as multiple sclerosis internationally;
•To develop and provide channels and facilities for continuing education and communication in the field, to publish and assist in the publishing of journals and other publications in the field;
•To provide information and advice on those aspects of public policy which are concerned with neurovascular disease and other related topics, and otherwise to perform charitable, scientific and educational functions with respect to studying such diseases in terms of research and treatment;
•To work with or for, and to co-operate with local, regional and national governments and governmental and private agencies, organizations, firms and institutions in efforts to accomplish one or more of the above purposes and
•To ensure that scientists and clinicians working in the field have equal and fair opportunities to contribute to it.

The ISNVD is dedicated to the dissemination and review of new concepts in etiopathogenesis, novel diagnostics and modes of therapeutic treatment in the diseases of the neurovasculature. The society does not endorse specific products, treatment modalities or procedures but encourages the free exchange of information which may lead to peer reviewed research and clinical studies.

Etiopathogenesis -- any help with that word? I know I can google it. " : the cause and development of a disease or abnormal condition." So a new concept in etiopathogenesis of MS is that impaired cerebrospinal venous drainage is a risk factor for developing MS and a worsening factor once MS has developed? Also interesting that it states that the society does not endorse specific treatments or procedures, which means it does not endorse CCSVI angioplasty, but encourages the free exchange of information which may lead to research on CCSVI (or other neurovascular conditions).

"To ensure that scientists and clinicians working in the field have equal and fair opportunities to contribute to it" -- if this is important enough to be mentioned, has there been inequality and unfairness in this regard? I do not like seeing a neurologist study on CCSVI that shuts out the contribution of interventional radiologists, for example. Traboulsee comes to mind.

[Cece]

https://isnvd.org/sites/default/files/I ... 16%20Final(1%29.pdf

Scientific Program and Agenda of the 6th International Society for Neurovascular Disease (ISNVD) Meeting, New York Academy of Sciences; 250 Greenwich St, New York, NY 10007, NYC, NY April 29th – 30th, 2016 Committee = Sal Sclafani, J. Steven Alexander, Alireza Minagar, Ziv Haskal, Felicity Gavins Theme: “How the extracranial venous system influences neurological diseases”
Fri, April 29:
8:00 – 9:00 AM - Executive committee meeting (venue tbd)
 9:00 – 9:30 AM – ISNVD President’s address – Dr. Salvatore Sclafani, MD; Radiology Brooklyn, NY, Professor of Radiology, SUNY Downstate, SUNY Upstate, Nassau University Medical Center
Session 1 - “Snapshots of Neurological Diseases with a Neurovascular Perspective : A Neurologic Point of View” 2 Hour Introductory session (9:30 – 11:00 AM) Chairs: Alireza Minagar, MD and Felicity Gavins, PhD (Theme - “Neurologists discussing vascular perspectives of disease”) 
9:30 – 9:50 AM - “Multiple sclerosis as a vascular disease”– Alireza Minagar, MD, FAAN 
9:50 – 10:10 AM - “Cerebral microbleeds project in age-related cerebral small vessel disease on cognition and age-related functional impairment”, Chih-Ping Chung, MD, PhD 
10:10 –10:30AM – “Cognition and Cerebral Hemodynamics in Human Disease” - Ronald M Lazar, PhD 
10:30 – 10:45 AM “Neurovascular Imaging in Epilepsy”, Hai Sun, MD, PhD 
10:45 – 11:00 AM -Platform talk #1 (David Utriainen) "Longitudinal Magnetic Resonance Imaging of Cerebral Microbleeds in MS Patients." 
Coffee break 11:00 -11:15 AM

 Session 2: “Heart & Brain Axis in Neurodegeneration” (11:15 – 12:40)
Chairs: Robert Zivadinov & Mat Daemen
 11:15 AM- 11:30AM – Mat Daemen, PhD - “Heart & Brain in Neurodegeneration –Arterial perspective” 
11:30AM-11:50 AM – Mark Van Buchem PhD – “The heart-brain axis from an imaging perspective” 
11:50AM-12:10 PM – Robert Zivadinov, PhD - “Heart & Brain in Neurodegeneration –Venous perspective” 
12:10 PM – 12:25 PM - Platform talk #2 Bernhard HJ Juurlink- "Arterial Pulse Pressure Waves Causing Endothelium & Myelin Damage May be a Causal Factor in MS”. 
12:25 PM – 12:40 PM - Platform talk #3 Robert Zivadinov – “Cerebral Microbleeds in MS; A Case-Control Study."

 Lunch break 12:40 – 2:15 PM

Session 3: “Imaging the microvasculature” - (2:15 – 4:35 PM)
Chairs: Mark Haacke, PhD, Felicity Gavins, PhD, D. Neil Granger, PhD 
2:15 - 2:35PM – Felicity Gavins, PhD, “Imaging Cellular Trafficking in the neurovasculature” 
2:35 -2:55PM – Mark Haacke, PhD - "Imaging the brain’s vasculature using MRI”
2
 2:55-3:15PM –Yulin Ge, MD, ”Gas-enhanced brain vascular imaging” 
3:15-3:35PM – Hongyu An, “Stroke penumbra imaging using a MR oxygen metabolic index”  Coffee break
3:35 -3:50 PM
 3:50 – 4:05 PM - Platform talk #4 Tamara Boltersdort - "Designing Novel Imaging Probes for Targeting Inflammatory Lesions in Brain Disorders." 
4:05 – 4:20 PM - Platform talk #5 (Jean-Christopher Brisset) "Introducing the Next Generation of Microvascular Imaging with a new USPIO-enhanced MRAV Approach." 
4:20 – 4:35 PM - Platform talk #6 Serena Monti - "Assessment of an Automated Vein Segmentation Algorithm for MRI Brain Acquisitions at Different Field Strengths"
4:35 - 6:00 poster session - Chairs: Hector Ferral, MD, Alireza Minagar, MD
 6:00PM - 7:00PM – Keynote speaker – Jonathan Kipnis, PhD, Director, Center for Brain Immunology and Glia (BIG), University of Virginia, School of Medicine. “Brain drain, meningeal lymphatics and neurological disorders” Chair: Dr. J. Steven Alexander, PhD – Vice-President
Welcome Cocktail Reception:  7:15 PM-9:00 PM – Central lobby – New York Academy of Sciences

Sat, April 30:
 7:00 - 8AM - ISNVD Board Member Meeting: (venue TBD)
Session 4: Assessment of Brain Hemodynamics in the Clinical Setting - (8:00 – 10:05 AM)
Chairs: Paolo Zamboni, MD, Marcello Mancini, MD  8AM - 8:20 AM – Lucia Monti, MD “Vascular factors and cerebral hemodynamics" 
8:20 - 8:40AM – Francesco Sisini, PhD, “Non-invasive methods to measure venous pressure and flow rate in jugular by ultrasound” 
8:40 - 9:00 - Marcello Mancini, MD, “Evaluation of cerebral hemodynamics with microbubble-enhanced ultrasound imaging and magnetic resonance imaging in MS patients” 
9:00 – 9:20AM – Erica Menegatti, PhD, “The relationship between jugular flow, ventricular volume, and brain perfusion at SPECT-CT in CCSVI patients” 
9:20 – 9:35 AM - Platform talk #7 Dejan Jakimovski" "Abnormal posture control of Internal Jugular Vein Flow is Associated with Brain Atrophy Progression in MS patients over 5 years" 
9:35 – 9:50 AM - Platform talk #8 "Noam Alperin. “Automated Real-Time Quantitative Total Cerebral Blood Flow by Phase Contrast MRI.” 
9:50 – 10:05 AM. Platform talk #9 Laura Pelizzari "A semi-automatic Method for Anatomical Measures of the Internal Jugular Veins.

 Coffee Break - 10:05 – 10:20 AM
3
 Session 5: “CSF Disturbances, Aging and Neurodegeneration” - (10:20 – 12:30 PM)
Chairs: Clive Beggs & Noam Alperin
 10:20 – 10:40 AM – Clive Beggs, PhD, “Retrospective overview of CSF and neurodegeneration work undertaken by members of ISNVD.” 
10:40 – 11:00 AM – Noam Alperin, PhD “ Origin and clinical relevance of the cranial spinal CSF pulsation” 
11:00 – 11:20 AM – Norman R. Relkin, MD “Reversal of periventricular white matter intensities in iNPH.” 
11.20 – 11:40 AM – Harold Rekate, MD, “Modifying CSF disturbances in hydrocephalus.” 
11:40 – 12:00 PM – Grant Bateman, MD “NPH, pseudotumor cerebri, leukoaraiosis, and pulse wave encephalopathy” 
12:00 – 12:15 PM – Platform talk #10 –Leonard Prouty "Discovering the Complex Genetics of Idiopathic Normal Pressure Hydrocephalus." 
12:15 – 12:30 PM - Platform talk #11 Sirin Gandhi, MD "No association of extra-cranial venous abnormalities & clinical outcomes in MS patients over 5 years."

 Lunch 12:30 – 1:45 PM
Session 6: “Vascular Interventions in Neurovenous disease ” - (1:45 – 3:50 PM)
Chairs Michael Dake, MD, Salvatore Sclafani, MD
 1:45 -2:05 PM - Ivo Petrov, MD, PhD – “Clinical outcomes of neurovenous angioplasty by a cardiologist” 
2:05 - 2:25 PM - Pierfrancesco Veroux, MD - “Clinical outcomes of jugular angioplasty by a vascular surgeon” 
2:25 – 2:45 PM - Hector Ferral, MD – “Clinical outcomes of a Dutch treatment registry” 
2:45 - 3:05 PM – Salvatore JA Sclafani, MD, FSIR – “Reasons for failure in neurovenous interventions” 
3:05 - 3:20 PM - Platform talk #12 Ivo Petrov "Endovascular Tx and Stem Cell Therapy of CCSVI" 
3:20 - 3:35 PM – Platform talk #13 Aldo Bruno "CCSVI Prevalence in Meniere's Disease and Preliminary Results of Balloon Venous Angioplasty." 
3:35 -3:50 PM –Platform #14 Pietro Maria Bavera. "Multiple Sclerosis and Symptom Changes after PTA: 4 year regular follow up on 366 Patients"

 3:50 -4:05 PM - Coffee break

Session 7 - Annette Funicello Research Foundation – (4:05 – 5:05 PM)
Chairs: Ziv Haskal, MD, Carol Schumacher
 4:05 -4:20 PM - Helen Kavnoudias “Randomised, double-blinded, controlled (with sham) study of percutaneous transluminal angioplasty for extracranial vein stenoses in patients with multiple sclerosis” 
4:20 -4:35 PM - Robert Zivadinov. “A case-control, 5-year follow-up study of cardiovascular, environmental and genetic risk factors for disease progression in patients with MS” 
4:35 -4:50 PM - Marcella Lagana. “Combined study of neurodegeneration, cerebrovascular reactivity and venous drainage impairments in Parkinson’s Disease (PD) and Multiple Sclerosis. 
4:50 - 5:05 PM – J. Winny Yun, J Steven Alexander - “Diagnostic and prognostic use of neurolymphatic biomarkers in MS”
 5:05 -5:20 PM - Coffee break
4

Session 8: “Vascular Function, Glymphatic System and New Drug Development.”
(5:20 PM – 7:05 PM) Chairs: Dr. J. Steve Alexander & Dr. Ikuo Tsunoda
 5:20 - 5:40 PM – Luke White, Ph.D.: “Alterations in Hemodynamic Flow Patterns and Endothelial Dysfunction in Neurodegeneration.” 
5:40 - 6 PM – Eleuterio Toro - “Progress towards a global circulation mathematical model, incorporating detailed CSF and lymphatics dynamics.” 
6:00 – 6:20 PM - Marie-Luce Bochaton-Piallat; “Structural Changes in extra-CNS Blood Vessels in Neurodegeneration.”  6:20 - 6:35 PM – Platform talk #15 - Christian Contarino - "First Step Towards a Mathematical Model for the Human Lymphatic System" 
6:35 - 6:50 PM – Platform talk #16 - Seiichi Omura - "Upregulation of Lymphatic Markers and Vascular Adhesion Molecules in CNS RNAseq Transcriptome of a Viral Model for MS" 
6:50 – 7:05 PM - Platform talk #17 - Miller Fawaz "Traumatic Brain Injury (TBI) Severity Quantification and Outcome Prediction Using MRI"
 GALA program and Dinner 
7:45 PM – Young Investigator Award @ Dinner venue

I have to read through all of this slowly! What looks most interesting?

[Cece]

10:45 – 11:00 AM -Platform talk #1 (David Utriainen) "Longitudinal Magnetic Resonance Imaging of Cerebral Microbleeds in MS Patients."

CCSVIAUSTRALIA on twitter has this to say from Dr. Utriainen on microbleeds: "Utriainen: people with MS may have more Microbleeds as they have more cardiovascular risk factors. #ISNVD"


So if we have more microbleeds, we'd have more immune activity to clean up the microbleeds in the brain, which could sensitize the immune system to attack the brain. Is that why cerebral microbleeds are important? What damage does a cerebral microbleed do? What medications can reduce the chances of cerebral microbleeds? What else did Dr. Utriainen say?

From Joan Beal on twitter:

Cerebral microbleeds may create MS lesions according to @GladstoneInst research on fibrinogen #ISNVD

How well do microbleeds show up on MRI? Is this a well accepted way to image them?

Microbleeds are a big topic, it seems, as there's an upcoming talk from Dr. Zivadinov on microbleeds as well: "12:25 PM – 12:40 PM - Platform talk #3 Robert Zivadinov – “Cerebral Microbleeds in MS; A Case-Control Study."

Zivadinov: 11.5% of MS compared to 5.1 of healthy controls found to have micro bleeds. 20% for those over 50 with MS c/f 7.4 of HCs.

[Cece]

4:20 – 4:35 PM - Platform talk #6 Serena Monti - "Assessment of an Automated Vein Segmentation Algorithm for MRI Brain Acquisitions at Different Field Strengths"

What is automated vein segmentation algorithms for MRI and how will it help with CCSVI research?

Serena Monti is from Italy. Looks like she received an award for best oral presentation last year at the 2015 ISNVD. That presentation was also on automated vein segmentation entitled, "Best Oral Abstract: Serena Monti - "Multiparametric automated segmentation of the Brain Veins."

[Cece]

9:20 – 9:35 AM - Platform talk #7 Dejan Jakimovski" "Abnormal posture control of Internal Jugular Vein Flow is Associated with Brain Atrophy Progression in MS patients over 5 years"

Association does not mean causal but I still want to learn much more about this.

Who is Dejan Jakimovski? Looks like he's at Buffalo BNAC:

Dejan Jakimovski is a medical graduate from Ss.Cyril and Methodius University, Skopje, Macedonia. His personal experience with MS made him pursue his career in this particular matter. While rotating in Neurology Department in Pauls Stradins Clinical University Hospital in Riga, Latvia and Radiology Department at University of Michigan Health System, Ann Arbor, Michigan, he strengthened his interest in Neurology and Neuroimaging. During his work in BNAC as Clinical Research Fellow he will focus on the 5 year follow-up study on the role of cardiovascular, environmental and genetic risk factors and their interactions on the clinical progression in MS patients and secondly on database required to create application which simplify the calculation of standardizable brain atrophy measures in clinical routine.

http://www.bnac.net/?page_id=1134

[Cece]

9:35 – 9:50 AM - Platform talk #8 "Noam Alperin. “Automated Real-Time Quantitative Total Cerebral Blood Flow by Phase Contrast MRI.”

Another one that stands out. Dr. Alperin has had good presentations in the past (on CSF pulsations and venous compliance) and I still don't fully understand his work. This would be an imaging how-to presentation and the imaging method could then be used in specific research.

10:40 – 11:00 AM – Noam Alperin, PhD “ Origin and clinical relevance of the cranial spinal CSF pulsation”

Another one from Noam Alperin. What is the clinical relevance of the cranial spinal CSF pulsation? I don't know but I am concerned now! Does pulsation create moments of high pressure?

[Cece]

11:00 – 11:20 AM – Norman R. Relkin, MD “Reversal of periventricular white matter intensities in iNPH.”

What factors allow the reversal to happen? Are they the same as when an MS lesion heals instead of becoming a black hole? Can we increase those factors in our MS brains? INPH is idiopathic normal pressure hydrocephalus.
and immediately following that is this:

11.20 – 11:40 AM – Harold Rekate, MD, “Modifying CSF disturbances in hydrocephalus.”

Yes, modifying! Not just noting that it exists but working to change it so CSF flow is improved and brains are protected. If it can be modified in hydrocephalus, can it be modified in MS?

[Cece]

12:15 – 12:30 PM - Platform talk #11 Sirin Gandhi, MD "No association of extra-cranial venous abnormalities & clinical outcomes in MS patients over 5 years."

Is there truly no association? What was the methodology and specifically the imaging of the extracranial venous abnormalities (was it robust and precise)? What would it mean if there is truly no association between ccsvi abnormalities and clinical outcomes? It is hard for me to believe that based on my anecdotal personal experience of improvements post-procedure, but my favorite improvement which is cogfog and energy levels is not one that would be easily measured in such a study.

Sirin Gandhi is at BNAC.

[Cece]

Ah, I've found the best session and it's tomorrow:

Session 6: “Vascular Interventions in Neurovenous disease ” - (1:45 – 3:50 PM) Chairs Michael Dake, MD, Salvatore Sclafani, MD

1:45 -2:05 PM - Ivo Petrov, MD, PhD – “Clinical outcomes of neurovenous angioplasty by a cardiologist” 
2:05 - 2:25 PM - Pierfrancesco Veroux, MD - “Clinical outcomes of jugular angioplasty by a vascular surgeon” 
2:25 – 2:45 PM - Hector Ferral, MD – “Clinical outcomes of a Dutch treatment registry” 
2:45 - 3:05 PM – Salvatore JA Sclafani, MD, FSIR – “Reasons for failure in neurovenous interventions” 
3:05 - 3:20 PM - Platform talk #12 Ivo Petrov "Endovascular Tx and Stem Cell Therapy of CCSVI" 
3:20 - 3:35 PM – Platform talk #13 Aldo Bruno "CCSVI Prevalence in Meniere's Disease and Preliminary Results of Balloon Venous Angioplasty." 
3:35 -3:50 PM –Platform #14 Pietro Maria Bavera. "Multiple Sclerosis and Symptom Changes after PTA: 4 year regular follow up on 366 Patients"

This is focusing specifically on the clinical interventions and outcomes of CCSVI angioplasty. If anyone there wants to take notes and share, this would be the session to do it. For the first three, when they say clinical outcomes, are they talking about MS-related clinical outcomes or specifically CCSVI-related clinical outcomes, such as whether the veins stay open and whether specific CCSVI symptoms are improved? From Dr. Sclafani's thread, do we know most of what he'll say about the reasons for failure in neurovenous interventions or is there new information or a more concise way to summarize or explain those reasons? Will those reasons for failure be well received by the professionals in attendance and influence the design of studies on CCSVI angioplasty?

Dr. Pietro Maria Bavera's study is here: https://translate.googleusercontent.com ... 9HQV5MXI8w
His conclusion, "The sooner the better," is memorable.

[Cece]

4:05 -4:20 PM - Helen Kavnoudias “Randomised, double-blinded, controlled (with sham) study of percutaneous transluminal angioplasty for extracranial vein stenoses in patients with multiple sclerosis”

This is the Australia study. Early results were promising but there were issues with the trial being underfunded for what they were attempting.
http://brainfoundation.org.au/wp-conten ... rosis-.pdf

Of 34 people who have been tested in this trial since September 2012, 27 have shown to have significant venous abnormalities, showing a trend that 80% of people with MS may be affected.

If our hypothesis is correct, we would expect to find an improvement in vision, mobility, balance, fatigue, cognition and heat tolerance as measured by the EDSS, MSFC, MSQoL-54 and CogState tests. Small scale studies have also documented an improvement following angioplasty, but in the absence of an RCT, it is impossible to evaluate the true efficacy of this treatment. Consequently, the outcomes of this trial will allow us to determine whether angioplasty for venous abnormalities in people with Multiple Sclerosis is a viable alternative to current treatments, and further, whether it may offer additional benefits that current pharmaceutical approaches cannot.

Very interested in this one.

[Cece]

5:20 - 5:40 PM – Luke White, Ph.D.: “Alterations in Hemodynamic Flow Patterns and Endothelial Dysfunction in Neurodegeneration.”

Does neurodegeneration itself, such as in MS, then alter the flow of hemodynamics, such as the autonomic nervous system dysfunction leading to impairment or reduction in cerebral blood flow? This might be looking at CCSVI from this other angle, which would be the MS neurodegeneration causing additional impairment in flow, but if we already start with impaired flow due to blockages, then having that impaired flow worsen due to effects from neurodegeneration might contribute to the increase in disability as the disease progresses. Also it is good to see endothelial dysfunction discussed at ISNVD and not just discussed here! Who is Luke White?

 6:00 – 6:20 PM - Marie-Luce Bochaton-Piallat; “Structural Changes in extra-CNS Blood Vessels in Neurodegeneration.”

Dr. Bochaton-Piallat's talk seems related as well. Are there changes in extracranial CNS blood vessels caused by neurodegeneration? Are there ways to tell what is caused by the neurodegeneration and what was pre-existing?

[Cece]

5:40 - 6 PM – Eleuterio Toro - “Progress towards a global circulation mathematical model, incorporating detailed CSF and lymphatics dynamics.”

6:20 - 6:35 PM – Platform talk #15 - Christian Contarino - "First Step Towards a Mathematical Model for the Human Lymphatic System"

6:00PM - 7:00PM – Keynote speaker – Jonathan Kipnis, PhD, Director, Center for Brain Immunology and Glia (BIG), University of Virginia, School of Medicine. “Brain drain, meningeal lymphatics and neurological disorders” Chair: Dr. J. Steven Alexander, PhD – Vice-President

I am also looking forward to the discussion of lympatics based on the rewrite-the-textbooks recent discovery that the brain does have a lympatic system like the rest of the body. And I would love to understand these mathematical models better.

[Cece]

This is from a month ago but it's Dr. Sclafani being interviewed about the sessions at ISNVD 2016 on YouTube. It's 16 minutes of audio.