OBJECTIVES: To evaluate the presence of chronic cerebrospinal venous insufficiency (CCSVI) and cerebral venous anomalies in a consecutive series of patients with multiple sclerosis (MS), other neurologic diseases (NEU) and healthy controls (HC). METHODS: A consecutive series of 80 MS patients, 41 HC and 26 NEU cases underwent a transcranial and extracranial echo-color Doppler (ECD) evaluation of cerebrospinal venous return in a sonographer-blinded fashion. According to the original Dr. Zamboni's protocol, CCSVI was diagnosed in presence of ≥2 ECD venous criteria. RESULTS: We did not observe any association between CCSVI and MS. CCSVI was detected in 17.5% of MS cases, 7.3% of HC and 11.5% of NEU patients (p=0.333). The prevalence of internal jugular vein stenosis (IJV) and the proportion of patients with any positive ECD criterion differed significantly among groups, being higher in MS cases versus HC (67.5% and 76.2% versus 48.8% and 41.5%, respectively; p=0.005 and p=0.006). No relationship between CCSVI and MS type and severity was evidenced. CONCLUSIONS: The present study argues against a positive link between CCSVI and MS risk or severity. Interestingly, a weak association between venous ECD anomalies (in particular IJV stenosis) and MS was observed in our population. This finding should be interpreted with caution due to the possible confounders and needs to be confirmed in large controlled studies.
OBJECTIVES: To evaluate the presence of chronic cerebrospinal venous insufficiency (CCSVI) and cerebral venous anomalies in a consecutive series of patients with multiple sclerosis (MS), other neurologic diseases (NEU) and healthy controls (HC). METHODS: A consecutive series of 80 MS patients, 41 HC and 26 NEU cases underwent a transcranial and extracranial echo-color Doppler (ECD) evaluation of cerebrospinal venous return in a sonographer-blinded fashion. According to the original Dr. Zamboni's protocol, CCSVI was diagnosed in presence of ≥2 ECD venous criteria. RESULTS: We did not observe any association between CCSVI and MS. CCSVI was detected in 17.5% of MS cases, 7.3% of HC and 11.5% of NEU patients (p=0.333). The prevalence of internal jugular vein stenosis (IJV) and the proportion of patients with any positive ECD criterion differed significantly among groups, being higher in MS cases versus HC (67.5% and 76.2% versus 48.8% and 41.5%, respectively; p=0.005 and p=0.006). No relationship between CCSVI and MS type and severity was evidenced. CONCLUSIONS: The present study argues against a positive link between CCSVI and MS risk or severity. Interestingly, a weak association between venous ECD anomalies (in particular IJV stenosis) and MS was observed in our population. This finding should be interpreted with caution due to the possible confounders and needs to be confirmed in large controlled studies.
Authors: Ian W Rodger; Dorothy Dilar; Janet Dwyer; John Bienenstock; Andu Coret; Judith Coret-Simon; Gary Foster; Arlene Franchetto; Slobodan Franic; Charles H Goldsmith; David Koff; Norman B Konyer; Mitchell Levine; Ellen McDonald; Michael D Noseworthy; John Paulseth; Luciana Ribeiro; Mary Jane Sayles; Lehana Thabane Journal: PLoS One Date: 2013-08-14 Impact factor: 3.240