via Sandro Rasman - Multiple Sclerosis and CCSVI: A Population-Based Case Control Study (full paper)

Francesco Patti1, Alessandra Nicoletti1, Carmela Leone1, Silvia Messina1, Emanuele D’Amico1, Salvatore Lo Fermo1, Vincenza Paradisi2, Elisa Bruno1, Graziella
Quattrocchi1, Pierfrancesco Veroux3, Luigi Di Pino4, Luca Costanzo4, Mario Zappia1*

1 Department DANA GF Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy, 2 FIMG (Italian Federation of General Medicine), Catania Municipality Section, Catania, Italy, 3 Department of Vascular Surgery, University of Catania, Catania, Italy, 4 Department of Cardiology, University of Catania, Catania, Italy

Abstract
Background
Chronic cerebrospinal venous insufficiency (CCSVI) has been associated to multiple sclerosis (MS).

Objective
To evaluate the possible association between CCSVI and MS, using a population-based control design.

Methods
A random cohort of 148 incident MS patients were enrolled in the study. We have also studied 20 patients with clinically isolated syndrome (CIS), 40 patients with other neurological diseases (OND), and 172 healthy controls. Transcranial (TCC) and Echo Color Doppler (ECD) were carried out in 380 subjects. A subject was considered CCSVI positive if =2 venous hemodynamic criteria were fulfilled.

Results
CCSVI was present in 28 (18.9%) of the MS patients, in 2 (10%) of CIS patients, in 11 (6.4%) of the controls, and in 2 (5%) of the OND patients. A significant association between MS and CCSVI was found with an odds ratio of 3.41 (95% confidence interval 1.63–7.13; p = 0.001). CCSVI was significantly more frequent among MS subjects with a disease duration longer than 144 months (26.1% versus 12.6% of patients with duration shorter than 144 months; p = 0.03) and among patients with secondary progressive (SP) and primary progressive (PP) forms (30.2% and 29.4, respectively) than in patients with relapsing remitting (RR) MS (14.3%). A stronger association was found considering SP and PP forms (age adjusted OR = 4.7; 95% CI 1.83–12.0, p = 0.001); the association was weaker with the RR patients (age adjusted OR = 2.58; 95%CI 1.12–5.92; p = 0.02) or not significant in CIS group (age adjusted OR = 2.04; 95%CI 0.40–10.3; p = 0.4).

Conclusions
A higher frequency of CCSVI has been found in MS patients; it was more evident in patients with advanced MS, suggesting that CCSVI could be related to MS disability.

read the full paper: http://www.plosone.org/article/info:doi/10.1371/journal.pone.0041227


PLoS ONE: Multiple Sclerosis and CCSVI: A Population-Based Case Control Study
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