Flow & anatomical abnormalities in MS vs Controls using MRI

[Cece]

Question: Does this study demonstrate that ALL MS patients present slow blood perfusion compared to controls regardless of whether they have stenosis or not? Thanks

ohhhh I want to know that too

The MS group showed lower normalized internal jugular vein (IJV) blood flow (tIJV/tA) than the HC group (P < .001). In the MS group, 72 (52%) were classified as ST while 66 (48%) were NST. In the HC group, 11 (23%) were ST while 37 (77%) were NST. The ST-MS group had lower IJV flow than both HC and NST-MS groups.

I wonder how the nonstenotic MS group compares to the nonstenotic healthy controls???
The question matters because we could put a number on what impairment occurs in MS patients due to reasons other than stenosis (or at least other than stenosis that is able to be visualized on MRI).

[brocktoon]

Question: Does this study demonstrate that ALL MS patients present slow blood perfusion compared to controls regardless of whether they have stenosis or not? Thanks

Perfusion is a different metric which we did not measure, but that has already been shown to be lower in MS compared to normals, most likely due to axonal degeneration, according to D'haeseleer et al. 2011.

This study does not demonstrate all MS have reduced blood flow & normalized flow in the IJVs, but the ones with abnormal IJV structure. The cohort of normals with stenosis was too small to make a claim, but HCs and NST we found had similar IJV flow. We will have higher subject samples and examine other venous routes in the next few works.

[cheerleader]

Perfusion is a different metric which we did not measure, but that has already been shown to be lower in MS compared to normals, most likely due to axonal degeneration, according to D'haeseleer et al. 2011.

Not to go OT, but hypoperfusion may also be due to impaired CVR--here's some important new research from another ISNVD member, Yulin Ge. Thought you mind find this of interest, Brocktoon.

Our quantitative imaging findings suggest impairment in functional cerebrovascular pathophysiology, by measuring a diffuse decrease in CVR, which may be the underlying cause of neurodegeneration in MS.

http://archneur.jamanetwork.com/article ... id=1893478

and hypoperfusion in MS has been linked to endothelial dysfunction and raised ET-1 in serum, which was reversed by administering bosentan.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3619305/

so--hypoperfusion may well be primary, and could be related to CCSVI, CVR and endothelial dysfunction...but that's not what this study was about, so I will now tiptoe back to my endothelial corner Carry on!
cheer

[1eye]

...I am not a doctor, and I do not recommend being treated without being tested (though I do think every "MS"er should be tested). The test may be the best thing you ever did for yourself. If you can afford the Haacke protocol, knowledge is power, and the more power the better. Remember many ultrasound operators do not know how to do this. Consult MarkW of Oxford's list of best practitioners. Good luck, all, and don't forget to buy the paper. After you do, let us know here in this thread.

Thanks to brocktoon, 1eye, Cece and cheerleader. I just bought the paper so will now read it. It IS exciting, but MS politics will be slow to adjust to the research. Too many vested interests. Thanks all.

Question: Does this study demonstrate that ALL MS patients present slow blood perfusion compared to controls regardless of whether they have stenosis or not? Thanks

No. This is not about perfusion. It does not show anything about ALL "MS" patients. It presents a statistical model and discovers that when divided into STENOTIC vs NON-STENOTIC groups, and when the total arterial blood flow is used to normalize measurements, STENOTIC "MS" patients (compared with healthy controls) have slower blood flow in their jugular veins. This means the stenosis is likely in their jugular veins.

I hope I have interpreted things correctly, and I welcome any corrections.