There is no evidence that impaired blood flow or blockage in the veins of the neck or head is involved in multiple sclerosis, according to a new paper in an open access journal.
The finding contradicts a hypothesis that says MS, a chronic, neurodegenerative and inflammatory disease of the central nervous system, is associated with abnormalities in the drainage of venous blood from the brain.
In 2008, Italian researcher Paolo Zamboni said that angioplasty, a blockage clearing procedure, would help MS patients with a condition he called chronic cerebrospinal venous insufficiency (CCSVI). This caused a flood of public response in Canada and elsewhere, with many concerned individuals lobbying for support of the 'Liberation Treatment' to clear the veins, as advocated by Zamboni.
The new research found no evidence of abnormalities in the internal jugular or vertebral veins or in the deep cerebral veins of any of 100 patients with multiple sclerosis (MS) compared with 100 people who had no history of any neurological condition.
Comparison of absolute mean flow values (mL/min ± SD) between MS patients (blue) and their matched controls (red) measured in the right and left IJVs at the high neck and mid-neck regions as well as in the straight sinus. No significant differences were found between MS subjects and controls.
"This is the first Canadian study to provide compelling evidence against the involvement of CCSVI in MS," said principal investigator Ian Rodger, a professor emeritus of medicine in the Michael G. DeGroote School of Medicine. "Our findings bring a much needed perspective to the debate surrounding venous angioplasty for MS patients".
In the study all participants received an ultrasound of deep cerebral veins and neck veins as well as a magnetic resonance imaging (MRI) of the neck veins and brain. Each participant had both examinations performed on the same day.
The McMaster research team included a radiologist and two ultrasound technicians who had trained in the Zamboni technique at the Department of Vascular Surgery of the University of Ferrara.
Citation: Citation: Ian W. Rodger, Dorothy Dilar, Janet Dwyer, John Bienenstock, Andu Coret, Judith Coret-Simon, Gary Foster, Arlene Franchetto, Slobodan Franic, Charles H. Goldsmith, David Koff, Norman B. Konyer, Mitchell Levine, Ellen McDonald, Michael D. Noseworthy, John Paulseth, Luciana Ribeiro, Mary Jane Sayles, Lehana Thabane, 'Evidence against the Involvement of Chronic Cerebrospinal Venous Abnormalities in Multiple Sclerosis. A Case-Control Study. PLoS ONE 8(8): e72495. doi:10.1371/journal.pone.0072495