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Study on CCSVI in MS at University of Wisconsin School of Medicine and Public Health

In June 2010, the National MS Society (USA) and the MS Society of Canada committed over $2.4 million to support seven new research projects on the role of CCSVI (chronic cerebrospinal venous insufficiency) in MS (http://www.nationalmssociety.org/ccsvi), an abnormality of blood drainage from the brain and spinal cord in MS originally reported by Dr. Paolo Zamboni. The new projects take a comprehensive look at the structure and function of veins draining the brain and spinal cord in people representing a spectrum of MS types, severities and durations, and compare them to structure and function of veins in people with other diseases and healthy volunteers. The studies incorporate high standards of experimental blinding and controls designed to provide unbiased results. Following is a description of one of the seven projects. Read the six month progress reports from all seven projects.

Title: “Study of CCSVI in MS using quantitative time-resolved 3D MRV”

Aaron Field MD, PhD
University of Wisconsin School of Medicine and Public Health
Madison, WI
Term/Amount: 7/1/10-6/30/12; $586,436

A series of recent publications have suggested that some people with MS have obstructions in the veins that drain blood in the brain and spinal cord that may contribute to nervous system damage in MS.

Dr. Field’s team is using alternative imaging methods, in addition to the ultrasound method used in Dr. Zamboni’s original reports, to conduct a controlled study of the CCSVI hypothesis in people with MS.

If this technique obtains similar results as the ultrasound method originally used, it would represent a powerful confirmation of the CCSVI hypothesis.

About the Investigator: Dr. Field is currently Associate Professor with Tenure in the Department of Radiology at UW-Madison with an affiliate appointment in Biomedical Engineering. He is Director of the Clinical Neuroradiology Fellowship Program and Co-Director of the Clinical Neurosciences Clerkship for UW medical students. Dr. Field completed the MD/PhD Program in Bioengineering at the University of Illinois College of Medicine at Chicago. Dr. Field's postgraduate training included a medical internship at Northwestern University/Evanston Hospital, residency in diagnostic radiology at Rush-Presbyterian-St. Luke's Medical Center in Chicago, and a fellowship in neuroradiology at Wake Forest University, Winston-Salem, NC. A primary goal of his research is non-invasive tracking of myelin repair following stem cell transplantation.

Dr. Field has put together a team that includes the director of the university’s MS clinic, experts in MRI physics and ultrasound, a neuroradiologist with extensive experience in vascular imaging, and a statistician with ample experience in clinical research.

Project Details: Recent preliminary studies have suggested that a phenomenon called Chronic Cerebrospinal Venous Insufficiency (CCSVI), a reported abnormality in blood drainage from the brain and spinal cord, may contribute to nervous system damage in MS. This hypothesis has been put forth by Dr. Paolo Zamboni from the University of Ferrara in Italy. This pilot study warrants a subsequent larger and better controlled study to definitively evaluate the possible impact of CCSVI on the disease process in MS.

Dr. Field’s team is using alternative imaging methods, in addition to the ultrasound method used in Dr. Zamboni’s original reports, to conduct a controlled study of the CCSVI hypothesis in people with MS. This study uses an MRI scanner to generate highly detailed images of the head and neck veins in 112 people with early and later MS, 56 controls without MS, and 56 people with other neurological conditions. The team is also measuring the rate at which blood flows in the veins. Dr. Field’s collaborates have years of experience in bioengineering, radiology, and medical physics.

If this technique obtains similar results as the ultrasound method originally used, it would represent a powerful confirmation of the CCSVI hypothesis and help lead the way toward trials of appropriate treatment targeting abnormal veins.

Quotes -- Dr. Aaron Field
“A relatively new theory on the nature of MS was recently proposed suggesting that MS is caused by chronically insufficient drainage of blood from the brain… If true, this would prompt a drastic change in our approach to MS treatment.”

“Currently, all the evidence for this theory has come from just one research group; it is now critical for other investigators, working independently, to confirm or refute this evidence. If our approach… obtains similar results, it would represent a powerful confirmation of this new theory and lead the way toward a larger-scale trial of appropriate treatment targeting the abnormal veins.”

http://www.nationalmssociety.org/research/intriguing-leads-on-the-horizon/ccsvi/ccsvi-study-by-field-team/index.aspx