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Published on: December 20, 2010
The perfect crime? CCSVI not leaving a trace in MS
Christoph A Mayer1, Waltraud Pfeilschifter, Matthias W Lorenz
1Department of Neurology, Goethe-University Frankfurt, Schleusenweg 2-16, 60528 Frankfurt am Main, Germany. christoph.mayer@kgu.de
This study found no evidence supporting chronic cerebrospinal venous insufficiency (CCSVI) in multiple sclerosis (MS) patients. The findings question the validity of CCSVI as a cause of MS.
Area of Science:
- Neurology
- Vascular Medicine
- Medical Imaging
Background:
- Multiple sclerosis (MS) is a chronic CNS inflammatory disease.
- A proposed mechanism, chronic cerebrospinal venous insufficiency (CCSVI), suggests venous drainage issues.
- CCSVI has gained media and scientific attention as a potential MS cause.
Purpose of the Study:
- To investigate the presence of CCSVI criteria in MS patients.
- To compare venous flow and structure in MS patients versus healthy controls.
- To evaluate the validity of CCSVI as a pathomechanism in MS.
Main Methods:
- Triple-blinded duplex sonography assessed extra- and intracranial venous flow.
- Internal jugular and vertebral vein cross-sectional areas (VCSA) were measured.
- Five CCSVI criteria, including stenosis and postural changes, were evaluated.
Main Results:
- No significant difference in retrograde flow or IJV-VCSA stenosis between MS patients and controls.
- Postural changes in IJV-VCSA were physiological and present in all participants.
- No MS patients met the criteria for CCSVI, while only one control did.
Conclusions:
- This sonographic assessment found no supportive evidence for CCSVI in MS patients.
- The findings challenge the proposed role of CCSVI in the pathomechanism of MS.
- The concept of CCSVI as a cause of MS is cast into serious doubt.
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