CCSVI and CCVBP

[NZer1]

Dr F, I am having trouble understanding if there is similarity in your explanation and this paper that is getting 'lots' of attention in CCSVI communities,

are you saying that the " The CNS doesn't have a lymphatic system " which would be a conflicting opinion to this paper?;

Abstract
One of the characteristics of the central nervous system is the lack of a classical lymphatic drainage system. Although it is now accepted that the central nervous system undergoes constant immune surveillance that takes place within the meningeal compartment, the mechanisms governing the entrance and exit of immune cells from the central nervous system remain poorly understood. In searching for T-cell gateways into and out of the meninges, we discovered functional lymphatic vessels lining the dural sinuses. These structures express all of the molecular hallmarks of lymphatic endothelial cells, are able to carry both fluid and immune cells from the cerebrospinal fluid, and are connected to the deep cervical lymph nodes. The unique location of these vessels may have impeded their discovery to date, thereby contributing to the long-held concept of the absence of lymphatic vasculature in the central nervous system. The discovery of the central nervous system lymphatic system may call for a reassessment of basic assumptions in neuroimmunology and sheds new light on the aetiology of neuroinflammatory and neurodegenerative diseases associated with immune system dysfunction.
http://www.ncbi.nlm.nih.gov/pubmed/26030524

Regards
Nigel

[uprightdoc]

Nigel,

I haven't read the paper yet. I only read the article by "Medical Press" and the abstract on Pubmed.

I stand corrected. I shouldn't have said that the CNS doesn't have a lymphatic system. I should have said that the brain and cord don't have a lymphatic system.

According to the article and abstract researchers "discovered functional lymphatic vessels lining the dural sinuses" that are able to transport fluid and immune cells from the CSF to the deep cervical lymph nodes. The dural sinuses are part of the pachymeninges that is formed into connective tissue tunnels lined with endothelium from veins. The dural sinuses are not part of the brain parenchyma. As far as we know at this time, there are no lymph vessels or lymph glands in the parenchyma of the brain and cord.

[Robnl]

hopefully this week a letter with appointment request/date.....for VU amsterdam dr de Jong....

[uprightdoc]

That's good news. Hopefully, Dr. De Jong has an open mind. Considering your signs, symptoms and history of playing soccer for many years you are an interesting case. They should send you to London.

[uprightdoc]

Robert,

Check out the link below to Professor Francis Smith's background. Make a copy and give it to your neurologist. Tell her that I suspect that there is a link between soccer and amyotrophic lateral sclerosis due to injuries to the craniocervical junction as a result of "heading the ball." You are a perfect case to study and Professor Smith is the perfect person to do the study on your craniocervical junction and craniospinal hydrodynamics.


http://www.mri-london.com/medserena-clinical-director/

[Robnl]

Thank you so much, doc!

[Robnl]

Hi doc,

I'm collecting info... for the appointment.
- Got dr smiths info
- Got your info (saw even a picture of you )
- saw also info on dr.harschfield
http://www.cellmedicinesociety.org/atta ... hfield.pdf
That's the one, right?
- got the presentation

Well, i feel confident about it...

[uprightdoc]

That's great Robert. Your neurologist can contact me if she has any questions. Based on your case history, I can practically guarantee that you have damage to the muscles and connective tissues coupled with chronic strains (misalignments) and deformation of the craniocervial junction causing obstruction to blood and CSF flow between cranial vault and spinal canal.

My next paper explains the connection to amyotrophic and primary lateral sclerosis (motor neuron diseases), which are cousin conditions to MS as far as I am concerned. You have a variant condition due to a similar cause with a different outcome. The common cause is injury to the craniocervical junction. Injuries to the craniocervical junction can be in the form of whiplash from motor vehicle accidents, a knock-out cross punch in boxing, a blow to the head from a fast pitch in baseball (Lou Gehrig), a blow to the head or whiplash from American football or heading the ball in soccer.

[Robnl]

Hi Doc,

Lately, i got the impression that i'm somewhat dizzy in the morning.It fades away during the day, does it has something to do with the spine?

[uprightdoc]

It certainly can have something to do with the spine Robert. Dizziness is a fairly common complaint with several different causes from sinus congestion to ear infections and decreased circulation to the brain. Musculoskeletal strains of the upper cervical spine and base of the skull can affect neurovascular pathways and sensory connections to the inner ear. They can also affect the pharynx, eustachian tube and endolymph in the ear.

[Robnl]

Hi Doc,

Do you have an opinion about the following?

Association Between Thoracic Spinal Cord Gray Matter Atrophy and Disability in Multiple Sclerosis.
Schlaeger R1, Papinutto N2, Zhu AH2, Lobach IV3, Bevan CJ2, Bucci M2, Castellano A2, Gelfand JM2, Graves JS2, Green AJ4, Jordan KM5, Keshavan A5, Panara V2, Stern WA2, von Büdingen HC2, Waubant E2, Goodin DS2, Cree BA2, Hauser SL2, Henry RG6.
Author information
Abstract
Importance:

In multiple sclerosis (MS), upper cervical cord gray matter (GM) atrophy correlates more strongly with disability than does brain or cord white matter (WM) atrophy. The corresponding relationships in the thoracic cord are unknown owing to technical difficulties in assessing GM and WM compartments by conventional magnetic resonance imaging techniques.
Objectives:

To investigate the associations between MS disability and disease type with lower thoracic cord GM and WM areas using phase-sensitive inversion recovery magnetic resonance imaging at 3 T, as well as to compare these relationships with those obtained at upper cervical levels.
Design, Setting, and Participants:

Between July 2013 and March 2014, a total of 142 patients with MS (aged 25-75 years; 86 women) and 20 healthy control individuals were included in this cross-sectional observational study conducted at an academic university hospital.
Main Outcomes and Measures:

Total cord areas (TCAs), GM areas, and WM areas at the disc levels C2/C3, C3/C4, T8/9, and T9/10. Area differences between groups were assessed, with age and sex as covariates.
Results:

Patients with relapsing MS (RMS) had smaller thoracic cord GM areas than did age- and sex-matched control individuals (mean differences [coefficient of variation (COV)]: 0.98 mm2 [9.2%]; P = .003 at T8/T9 and 0.93 mm2 [8.0%]; P = .01 at T9/T10); however, there were no significant differences in either the WM area or TCA. Patients with progressive MS showed smaller GM areas (mean differences [COV]: 1.02 mm2 [10.6%]; P < .001 at T8/T9 and 1.37 mm2 [13.2%]; P < .001 at T9/T10) and TCAs (mean differences [COV]: 3.66 mm2 [9.0%]; P < .001 at T8/T9 and 3.04 mm2 [7.2%]; P = .004 at T9/T10) compared with patients with RMS. All measurements (GM, WM, and TCA) were inversely correlated with Expanded Disability Status Scale score. Thoracic cord GM areas were correlated with lower limb function. In multivariable models (which also included cord WM areas and T2 lesion number, brain WM volumes, brain T1 and fluid-attenuated inversion recovery lesion loads, age, sex, and disease duration), cervical cord GM areas had the strongest correlation with Expanded Disability Status Scale score followed by thoracic cord GM area and brain GM volume.
Conclusions and Relevance:

Thoracic cord GM atrophy can be detected in vivo in the absence of WM atrophy in RMS. This atrophy is more pronounced in progressive MS than RMS and correlates with disability and lower limb function. Our results indicate that remarkable cord GM atrophy is present at multiple cervical and lower thoracic levels and, therefore, may reflect widespread cord GM degeneration.

http://www.ncbi.nlm.nih.gov/pubmed/?ter ... lity+in+MS

[uprightdoc]

Hello Robert,

The study you linked to is interesting and yes I do have an opinion regarding degeneration of the gray matter of the upper cervical and thoracic cord and the increase in disability. I will explain the connection in my next paper which includes ALS. Hopefully it gets published. I should know in the next several weeks whether the paper is accepted or rejected. If it does get published we can discuss the details.

[Robnl]

http://bradscholars.brad.ac.uk:8080/han ... 7321[quote]

live Beggs work seeks to bring clarity to the debate surrounding CCSVI by characterizing physiological changes associated with constricted cerebral venous outflow. The work submitted here involves collaborative studies with Robert Zivadinov (University of Buffalo), Paolo Zamboni (University of Ferrara), and Chih- Ping Chung (National Yang Ming University of Medicine).

The key findings of these studies are:
(i) MS patients, diagnosed with CCSVI, exhibit greatly increased hydraulic resistance of the cerebral venous drainage system;

(ii) MS patients experience loss of the small cerebral veins;

(iii) MS patients exhibit reduced CSF bulk flow, consistent with mild venous hypertension;

(iv) MS patients exhibit increased CSF pulsatility in the Aqueduct of Sylvius, which appears to be linked with mild venous hypertension associated with CCSVI; and

(v) jugular venous reflux is associated with white matter and parenchymal volumetric changes in Alzheimer’s patients.

Collectively, these findings suggest that extracranial venous anomalies are associated with changes in the intracranial physiology. [/quote]

[uprightdoc]

Thanks Robert. It took awhile to read but it was an interesting dissertation. Much more needs to be done though. The paper simply scratches the surface. There is a full spectrum of conditions related to venous hypertension from childhood conditions such as hydrocephalus to neurodegenerative conditions in adults. Nothing was mentioned in the paper regarding the potential role of the craniocervical junction and lower spine in venous hypertension and faulty craniospinal hydrodynamics.

[Robnl]

http://www.nature.com/sc/journal/v42/n4 ... 1517a.html

weird that there is not much attention for these cases