Dr. Andreas Laupacis is shown in Toronto on May 16, 2010. The science available to date supports the idea there may be a link between a condition called CCSVI and multiple sclerosis, says a new study that nevertheless warns it is too soon to draw "definitive conclusions." THE CANADIAN PRESS/HO, Alberta health Sevices - Tim Fraser

TORONTO - The science available to date supports the idea there may be a link between a condition called CCSVI and multiple sclerosis, says a new study that nevertheless warns it is too soon to draw "definitive conclusions."

The study, which informed the federal government's decision to go ahead with clinical trials into a possible treatment for the condition, was published Monday in the Canadian Medical Association Journal.

The research was led by Dr. Andreas Laupaucis, director of the Li Ka Shing Knowledge Institute at Toronto's St. Michael's Hospital. Laupaucis, an internal medicine specialist, admitted he was doubtful about CCSVI when he started the study.

"I went into this pretty skeptical, thinking we'd find nothing there. I'm not personally still convinced that there's an association, but looking at this now I guess I'd sort of say: Well, I'm a little more willing to accept that maybe there is something there," he said in an interview.

The work is what is called a meta-analysis. Rather than run new clinical trials, the researchers amalgamated data from eight previously conducted trials into a controversial treatment for CCSVI. The idea behind this type of study is that by combining data from a number of similar small studies, a clearer picture can sometimes come into focus.

Multiple sclerosis is a degenerative neurological disease long thought to be the result of problems with the autoimmune system. But in the past few years an Italian vascular surgeon named Paolo Zamboni has taken the MS world by storm, theorizing that the disease is caused by blocked veins in the neck and spinal cord.

Zamboni said those blockages, seen using ultrasound, are actually a medical condition. He dubbed it chronic cerebrospinal venous insufficiency, or CCSVI.

The blockages prevent blood from draining from the brain, allowing a buildup of substances such as iron, Zamboni suggested. He argues that opening the veins using angioplasty significantly alleviates the debilitating symptoms MS patients experience.

Scores of Canadians with MS have travelled to Europe and beyond to undergo the procedure, which is not currently licensed in Canada.

While Zamboni's theory has met with enthusiasm on the part of many desperate patients, neurologists — the medical specialists who treat MS — have been skeptical about the new notion of what is causing the disease.

The Laupaucis meta-analysis looked at data from 644 people with MS, compared in the eight studies to an equal number of people who didn't have the disease, called "controls" in the language of studies. Some of the controls were healthy adults. Some had other neurological conditions.

The analysis found a statistically significant association between MS and CCSVI. That means more people with MS had blocked veins than did the controls. The term statistically significant means that the findings don't look like they could be the product of chance.

To try to ensure that the findings weren't being driven by Zamboni's original study — which found CCSVI in 100 per cent of MS patients but in none of the controls — the researchers ran some additional analyses looking at what happened if Zamboni's cases were left out of the calculations. Even without them, it looked like more MS patients than non-MS patients had CCSVI.

That was not true, though, when MS patients were compared to controls who had other neurological conditions. In that comparison the difference was not statistically significant.

A puzzling aspect of the study related to the enormous differences between the rates of CCSVI in MS patients in the various trials. At one end, Zamboni found the condition in all of his MS patients. But another group found it in none of the MS patients they examined.

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