From a "big picture" perspective of the role that chronic cerebrospinal venous insufficiency (CCSVI) plays in MS, I honestly don't know what the results mean. I don't think anyone else claims to know, either.
In the most simple terms, here is what the data from the recent study conducted at the University of Buffalo says (from the data I have gleaned from the press release):
People with multiple sclerosis (MS) are 2.5 times as likely to have CCSVI than people without MS.
Now, this is in contrast to the previous studies from Dr. Zamboni and his colleagues, which were more along the lines of almost everyone they tested with MS had CCSVI and pretty much everyone without MS who was tested did not have CCSVI. Putting numbers to those results came out to something along the lines of "people with MS are 43 times more likely to have CCSVI than people without MS."
"Why is there such a big difference in the odds?" you may ask. I'm a little curious myself. There could be a number of different reasons and I am hesitant to speculate until I have seen the detailed results of the study and can compare methodologies side-by-side (the preliminary results of the Buffalo study were released in a press release, rather than waiting to publish in a journal, which is unusual but was probably done in response to the huge interest in this theory and this study from the MS community).
So, where does this leave us? First off, I am sure there are many disappointed people out there who liked the clear-cut answers that they were initially getting from the CCSVI theory when it was supported by an almost 100% correlation with MS. I am sorry (really) for all of us that the answer was not that black-and-white - once again, we are living in the land of gray with our MS.
Many things have been cast into doubt. Dr. Robert Zivadinov, the study's principle investigator, saying that he doesn't recommend having any surgery or procedure at this time, as "we don't know whether the endovascular treatment is helping or not." There seems to be some question what it means that people with more advanced MS have worse CCSVI, leading researchers to ask again if MS is contributing to the CCSVI or vice versa.
On the other side of the fence are those people who have gone ahead and had the surgery and have experienced huge improvements in their symptoms. For the individual who has actually felt improvement in fatigue, muscle weakness, cognitive dysfunction and any of the other things that come along with MS, statistics are meaningless. These people deserve our attention and respect for their experiences, too. (To read some of these, start here: CCSVI Treatment Reports from Patients)
My bottom line: I remain positive about the CCSVI theory. Clearly, something is happening here. I am also a little more comfortable with the newer numbers - as an epidemiologist, we were trained to be very wary of claims of "100%!" and words like "everybody" or "nobody." Let's stay tuned for what the science and the people turn up in the next couple of months.
How do you feel about the new developments? State your opinion in the comment section below.