The MS Society Funded doppler/MR study of CCSVI out of Houston, TX, was presented at the American Academy of Neurologist conference....or should I say, the American Brain Foundation conference...

Cat Smith had a great comment on this rebranding of the AAN.  

"Does this mean we have to call them brainiologists now???"

The results of this study were not good.  This team did not use Dr. Zamboni's doppler US method,  as has the Cleveland Clinic and BNAC (both groups which trained with Dr. Zamboni's team have found CCSVI in those with MS)  It is impossible to tell how "serial ultrasound scans" were utilized by reading the abstract.  That's all we have for now, since this is preliminary, and the research is not published yet.  

Per usual, Dr. Mark Freedman adds his ever-compassionate and pithy comments on this study in an interview for Medpage.  

Mark Freedman, MD, of the University of Ottawa in Ontario, pointed out after Barreto's presentation that serial ultrasound scans would have made the findings more reliable, as venous sonography results tend to be variable within patients.

Nevertheless, he told MedPage Today, CCSVI had already been essentially ruled out as a contributor to MS.

"There are just some people who are convinced that neurologists don't know what they're doing. The data [that CCSVI is unrelated] is pretty convincing," Freedman said.

Asked if there was a role for using a series of imaging studies -- ultrasound followed by MR and CT venography, for example, he responded, "You know the expression about a dead horse?"

link to medpage

Here is the abstract, the Barreto/Wolinsky study out of Texas--funded by the NMSS.

[S10.005] A Study of CCSVI with Imaging-Blinded Assessment: Neurosonography Update

Andrew Barreto, Staley Brod, Thanh-Tung Bui, James Jamelka, Larry Kramer, Kelly Ton, Alan Cohen, John Lindsey, Flavia Nelson, Ponnada Narayana, Jerry Wolinsky, Houston, TX 

OBJECTIVE: Does chronic cerebrospinal venous insufficiency (CCSVI) exist, is it associated with multiple sclerosis (MS), and what tools might establish its presence? We sought to determine if neurosonography (NS) provides reliable information on cerebral venous outflow patterns, if NS findings are supported by 3T magnetic resonance venography (MRV), and if NS and/or MRV reflect transluminal venography findings. We detail NS findings on the first 193 participants. 

BACKGROUND: CCSVI is postulated to have a role in MS pathogenesis. 

DESIGN/METHODS: TB, blind to the subject's diagnosis, used high resolution B-mode imaging with color and spectral flow Doppler to investigate extracranial and intracranial venous drainage. Results were evaluated by ADB with neither subject contact nor patient information; only KT and JSW could access the complete database. 

RESULTS: 10 healthy controls, 18 cerebrovascular diseases, 27 other neurological diseases, 138 MS (7 clinically isolated syndrome, 80 relapsing remitting, 35 secondary progressive, 15 primary progressive, 1 progressive relapsing) were studied. MS patients were older than non-MS subjects (48.4±9.8 v 44.3±11.4 years), durations from first symptoms and diagnosis of 13.7±9.4 and 10.3±8.0 years, and EDSS 2.9±2.0. 47 subjects fulfilled one of five criteria for CCSVI proposed by Zamboni; 8 fulfilled two criteria and none fulfilled >2 criteria. The distribution of subjects with 0, 1 or 2 criteria did not differ significantly across all diagnostic groupings, between MS and non-MS subjects, or within the MS subgroups. No significant differences emerged between MS and non-MS subjects for measures of cross-sectional areas of the internal jugular veins at fixed anatomic sites or for extracranial or intracranial venous flow rates.

CONCLUSIONS: NS findings described as CCSVI are much less prevalent than previously reported and do not distinguish MS from other subjects. Data will be updated prior to the meeting. Correlations of NS and MRV for 37 MS subjects are reported separately. Supported by: National Multiple Sclerosis Society (RC 1019-A-5).Category - MS and Related Diseases: Clinical Science

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What I found most interesting about this study was this---and it was only reported on Medpage, not in the abstract:

Of the 20 comparisons between MS and non-MS participants, one showed a significant difference. That was cross-sectional area of the left internal jugular vein (mean 17 cm2 in MS patients versus 22 cm2 in controls, P=0.03).

Why would people with MS have substantially smaller internal jugular veins?  One would hope this team looks futher.  I'd also hope they consult with BNAC, or Cleveland Clinic, or maybe Dr. Zamboni, to learn what specifically to be looking for in CCSVI, and how to do the scans.  Because it makes a difference.  And the horse is far from dead, Dr. Freedman, our favorite "brainiologist."

onward,

Joan