Slowed perfusion in the MS brain- new paper by Dr. Simka

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.
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cheerleader
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Slowed perfusion in the MS brain- new paper by Dr. Simka

Post by cheerleader »

Thank you, Dr. Simka- for pursuing this line of reasoning-
J Neurosci Res. 2010 Feb 1. [Epub ahead of print]
Reinterpreting the magnetic resonance signs of hemodynamic impairment in the brains of multiple sclerosis patients from the perspective of a recent discovery of outflow block in the extracranial veins.
Simka M, Zaniewski M.

Private Healthcare Institution SANA, Department of Angiology, Pszczyna, Poland.

Multiple sclerosis patients examined with perfusion magnetic resonance (MR) imaging techniques have been found to have patterns of abnormal blood flow. These include prolonged mean transit time, a trend toward decreased cerebral blood flow in the area of plaques, and decreased cerebral blood flow and prolonged mean transit time within normal-appearing white matter. Increased cerebral blood flow and volume and decreased mean transit time (compared with the baseline values before the relapse) were found to precede the development of plaques. In addition, susceptibility-weighted imaging utilizing deoxyhemoglobin as the contrast has revealed that venous blood in cerebral veins of multiple sclerosis patients is less deoxygenated compared with healthy controls. All these findings were traditionally interpreted as a sign of local flow disturbances mediated by inflammatory and neurodegenerative processes. However, recent findings of significant stenoses in the extracranial veins that drain the brain and spinal cord shed new light on these MR results. With the assumption that a majority, if not all, of multiple sclerosis patients exhibit such extracranial venous obstacles, the perfusion MR images of multiple sclerosis patients should be reinterpreted. Perhaps ongoing MR studies with respect to extracranial venous hemodynamics may decipher some of the unsolved puzzles related to this neurologic disease. (c) 2010 Wiley-Liss, Inc.
link

We've discussed slowed perfusion in relation to CCSVI here
http://www.thisisms.com/ftopict-7708-perfusion.html

cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
Rokkit
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Post by Rokkit »

For some reason I just like reading this line over and over:
With the assumption that a majority, if not all, of multiple sclerosis patients exhibit such extracranial venous obstacles, the perfusion MR images of multiple sclerosis patients should be reinterpreted.
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Asher
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Post by Asher »

This guy Simka is going to make history, either as a con, or as an angel.
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gibbledygook
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Post by gibbledygook »

Does anyone know/think that low blood pressure lowers the transit time of blood through the brain? I'm guessing that low blood pressure would slow things down. My BP is currently 70 over 40 and my MS symptoms especially walking are especially poor at the moment. I can't wait for the third term of my pregnancy when blood pressure goes back up!
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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gibbledygook
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Post by gibbledygook »

In addition, susceptibility-weighted imaging utilizing deoxyhemoglobin as the contrast has revealed that venous blood in cerebral veins of multiple sclerosis patients is less deoxygenated compared with healthy controls.
Didn't he mean is more deoxygenated? Less deoxygenated would imply that it had more oxygen than controls. At least that's my interpretation. I'm confused. I though hypoxia meant less oxygen. :?
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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Post by LR1234 »

I think he meant to write less oxygenated maybe
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gibbledygook
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Post by gibbledygook »

Well, it looks like hypotension could cause hypoperfusion but I didn't find a whole lot on Pubmed. I think the med world has been so obsessed with high blood pressure and the arterial system that Simka et al are really onto a good new area of research.
Clin Exp Hypertens. 2008 Nov;30(8):711-9.

Cognitive decline and low blood pressure: the other side of the coin.
Maule S, Caserta M, Bertello C, Verhovez A, Naso D, Bisbocci D, Veglio F.

Division of Medicine and Hypertension, Department of Medicine and Experimental Oncology, S. Giovanni Battista Hospital, University of Torino, Torino, Italy. simmaule@tin.it

Low blood pressure has been found to be associated with cognitive decline and dementia in cross-sectional studies. Two mechanisms have been proposed to interpret this association: blood pressure levels decrease during the course of the dementia process, and low blood pressure induces or accelerates cognitive decline by lowering cerebral blood flow. Results of the prospective studies are contradictory. Low blood pressure and orthostatic hypotension have been found to predict cognitive impairment in the elderly population in some studies only. While hypotension may play a protective role in healthy elderly people, low blood pressure levels in frail elderly patients with associated diseases may cause cerebral hypoperfusion and accelerate cognitive decline.

PMID: 19021022 [PubMed - indexed for MEDLINE]
3 years antibiotics, 06/09 bilateral jug stents at C1, 05/11 ballooning of both jug valves, 07/12 stenting of renal vein, azygos & jug valve ballooning,
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fogdweller
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Re: Slowed perfusion in the MS brain- new paper by Dr. Simka

Post by fogdweller »

cheerleader wrote:. However, recent findings of significant stenoses in the extracranial veins that drain the brain and spinal cord shed new light on these MR results. With the assumption that a majority, if not all, of multiple sclerosis patients exhibit such extracranial venous obstacles, the perfusion MR images of multiple sclerosis patients should be reinterpreted. Perhaps ongoing MR studies with respect to extracranial venous hemodynamics may decipher some of the unsolved puzzles related to this neurologic disease. (c) 2010 Wiley-Liss, Inc.
cheer[/quote]

I personally think one of the most exciting aspects of CCSVI is that it is opening a whole new line of thinking and questioning that will lead to whole new lines of research ,,, AND HOPEFULLY ANSWERS!

Just read the thread about "My Strange, unexplainable liberation procedure" to see an example of how that plays out. No answers there yet but whole new pieces of the puzzle to fit together.
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gauchito
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Post by gauchito »

All in all, after reading scientific papers you read, and sharing thoughts that you place in this wonderful forum (i just joined 2 months ago and am very proud!) I feel that this new exciting movie we are watching has 4 main characters:

- vasculature
- ferrum
- oxygen
- CSF dynamics (ventricles in the brain)

In my view, by coherently integrating all those characters´interplay we will have resolved a 150 year mistery and get together for a beer!
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prairiegirl
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Post by prairiegirl »

The resolution of a 150 year old mystery... I'll drink to that!
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