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Normal CSF ferritin levels in MS suggest against etiologic role of chronic venous insufficiency

V Worthington1, J Killestein, M J Eikelenboom

  • 1Department of Neuroimmunology, UCL Institute of Neurology, University College London, Queen Square, London, UK.

Neurology
|October 1, 2010
PubMed
Abstract

Insights

This study found no evidence that chronic cerebrospinal venous insufficiency (CCSVI) causes multiple sclerosis (MS) through iron deposition. Cerebrospinal fluid ferritin levels were not elevated in MS patients, refuting the proposed mechanism.

Area of Science:

  • Neuroimmunology
  • Vascular Neurology
  • Neurodegenerative Diseases

Background:

  • Chronic cerebrospinal venous insufficiency (CCSVI) is a controversial hypothesis linking venous abnormalities to multiple sclerosis (MS).
  • The proposed mechanism involves venous stasis leading to iron deposition in brain tissue and subsequent neurodegeneration.

Purpose of the Study:

  • To investigate the potential role of CCSVI in MS pathogenesis by examining intrathecal iron transport.
  • To assess cerebrospinal fluid (CSF) ferritin levels as a biomarker for iron deposition in MS and other neurological conditions.

Main Methods:

  • A cross-sectional study of 1,408 patients and a longitudinal study of 29 patients with MS and other neurological disorders.
  • Measurement of cerebrospinal fluid (CSF) ferritin levels to evaluate iron transport and deposition.

Main Results:

  • Elevated CSF ferritin levels were found in conditions like superficial siderosis and subarachnoid hemorrhage, but not significantly in MS patients.
  • Only 10-23% of MS patients exhibited mildly elevated CSF ferritin, with no significant changes over a 3-year follow-up.
  • Control patients had low median CSF ferritin levels (4 ng/mL).

Conclusions:

  • The findings do not support an etiological role for CCSVI-related parenchymal iron deposition in the development of MS.
  • The proposed mechanism of venous stasis-induced iron deposition as a cause of MS is not substantiated by these data.

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