Main idea of this article: If there is in fact a link between CCSVI and multiple sclerosis (MS), could it be that MS is causing the CCSVI instead of the CCSVI causing the MS? Read on...
I deliberately titled this blog in a provocative manner as bait to get some of my more vociferous CCSVI-expert readers over here. I genuinely want to know what you all think of this study. (For a quickie primer on CCSVI, read: What is CCSVI in Multiple Sclerosis?)
Without offering my opinion, I'll give a little outline of the main points of the study that appeared in the January issue of the Annals of Neurology. The full text of the study is available here: No evidence of chronic cerebrospinal venous insufficiency at multiple sclerosis onset.
Here are some highlights:
- 50 people with possible MS (with clinically-isolated syndrome (CIS), but also dissemination in space of inflammatory lesions) had a diagnostic workup with extracranial and transcranial venous echo-color Doppler sonography. People with CCSVI had further selective venography. This group was age and gender matched with a control group of healthy subjects.
- Venous sonography results were abnormal in 52% of people with possible MS and in 32% of healthy controls.
- 16% of people with possible MS were diagnosed with CCSVI, but selective phlebography (recording the venous pulse, or how the blood moves through the veins) in these people did not show venous anomalies.
What could this mean?
The research team notes that the people in studies by Dr. Zamboni, Dr. Simka, Dr. Zivadinov and others (all of whom found very high percentages of people with MS having CCSVI) had well-established MS. The people in this study only had a CIS, meaning about half of them were expected to convert to a definitive MS diagnosis within a couple of years. These people could be said to have "pre-MS" or MS that is in the very earliest stages, as MS cannot be diagnosed until there are lesions disseminated in time (separated by at least 30 days), as well as in space (in different parts of the spine and brain). (To learn more about this, read: Is there a test to determine if you have MS after one attack?) There is also some discussion in the article of differences in instrumentation and interpretation of results possible skewing the results of Zamboni's (and others') studies towards many CCSVI false positives, meaning they were considered to have CCSVI when they really did not.
Some thoughts are that CCSVI might be linked to later stages of MS, or progressive forms of MS. This means that (according to the researchers behind this study) CCSVI does NOT cause MS. To follow this logic would indicate that there is a possibility that it is the MS that causes the CCSVI and not the other way around.
Okay, now I am turning it over to you. What do you think about this study? What are some explanations? What is the word on the street about the assertion that CCSVI does not cause MS? Leave your thoughts in the comments section below.