Author: MS Trust

A meta-analysis of eight studies of chronic cerebro-spinal venous insufficiency which compared people with MS to healthy controls or those with other neurological conditions found CCSVI more common in people with MS.

Chronic cerebro-spinal venous insufficiency (CCSVI) is a theory proposed by Professor Paolo Zamboni, a vascular surgeon at the University of Ferrara in Italy. He suggests that in people with multiple sclerosis an abnormal narrowing in veins taking blood from the brain causes a build up of iron which crosses the blood brain barrier damaging cells in the central nervous system.The hypothesis is currently the subject of intensive research and the findings of these studies are variable and have resulted in considerable controversy amongst clinicians and people with MS.

A new meta-analysis commissioned by the Canadian Institutes of Health Research has examined eight published studies that evaluated the association between chronic cerebro-spinal venous insufficiency and multiple sclerosis. The studies examined a total of 664 patients with MS and an equal number of controls (136 of whom had neurological conditions other than MS). The authors found that CCSVI was more frequent among people with MS than amongst healthy controls. However the prevalence of CCSVI in people with MS varied widely and this meta-analysis cannot differentiate between causal and non-causal associations.

The authors conclude that "further high quality studies, using identical ultrasound protocols, are needed to definitively determine whether chronic cerebrospinal venous insufficiency is more frequent among patients with multiple sclerosis than among those without it."

Dr Robert Fox from the Mellen Center for Multiple Sclerosis Treatment and Research at the Cleveland Clinic, in a commentary in the Canadian Medical Association Journal suggested that the findings of CCSVI during ultrasound may be the result of mild dehydration, this being preferred in people with multiple sclerosis and neurogenic bladders.

http://www.mstrust.org.uk/news/article.jsp?id=4983