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Tuesday, April 19, 2011 7:30 PM
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Ken Torbert
Prevalence, sensitivity, and specificity of chronic cerebrospinal venous insufficiency in MS
- R. Zivadinov, MD, PhD,
- K. Marr, RVT, RDMS,
- G. Cutter, PhD,
- M. Ramanathan, PhD,
- R.H.B. Benedict, PhD,
- C. Kennedy, LMSW, MPH,
- M. Elfadil, MD,
- A.E. Yeh, MD,
- J. Reuther, BA,
- C. Brooks, BA,
- K. Hunt, BA,
- M. Andrews, BA,
- E. Carl, BA, MS,
- M.G. Dwyer, BS, MS,
- D. Hojnacki, MD and
- B. Weinstock-Guttman, MD
+ Author Affiliations
- From the Buffalo Neuroimaging Analysis Center (R.Z., K.M., C.K., M.E., J.R., C.B., K.H., M.A., E.C., M.G.D.), The Jacobs Neurological Institute, Department of Neurology, University at Buffalo (R.Z., M.R., R.H.B.B., A.E.Y., D.H., B.W.-G.), and Department of Pharmaceutical Sciences (M.R.), State University of New York, Buffalo; and Department of Biostatistics (G.C.), University of Alabama, Birmingham.
- Address correspondence and reprint requests to Dr. Robert Zivadinov, Department of Neurology, School of Medicine and Biomedical Sciences Buffalo Neuroimaging Analysis Center, 100 High St., Buffalo, NY 14203 rzivadinov@bnac.net
AbstractBackground: Chronic cerebrospinal venous insufficiency (CCSVI) was recently described in patients with multiple sclerosis (MS). A subject is considered CCSVI positive if =2 venous hemodynamic (VH) criteria are fulfilled. Objective: To determine prevalence of CCSVI in a large cohort of patients with MS, clinically isolated syndrome (CIS), other neurologic diseases (OND), and healthy controls (HC), using specific proposed echo-color Doppler (ECD) criteria. Methods: Transcranial and extracranial ECD were carried out in 499 enrolled subjects (289 MS, 163 HC, 26 OND, 21 CIS). Prevalence rates for CCSVI were calculated in 3 ways: first, using only the subjects for whom diagnosis was certain (i.e., borderline subjects were excluded); secondly, including the borderline subjects in the “no CCSVI” group; and finally, taking into account subjects who presented any of the VH criteria. CCSVI prevalence with borderline cases included in the “no CCSVI” group was 56.1% in MS, 42.3% in OND, 38.1% in CIS, and 22.7% in HC ( p < 0.001). The CCSVI prevalence figures were 62.5% for MS, 45.8% for OND, 42.1% for CIS, and 25.5% for HC when borderline cases were excluded ( p < 0.001). The prevalence of one or more positive VH criteria was the highest in MS (81.3%), followed by CIS (76.2%), OND (65.4%), and HC (55.2%) ( p < 0.001). CCSVI prevalence was higher in patients with progressive than in nonprogressive MS ( p = 0.004).
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