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Winnipeg Free Press - PRINT EDITION

U.S. study backs up theory over risk factor for MS

By: Staff Writer

Posted: 02/11/2010 1:00 AM | Comments: 0 (including replies)

TORONTO -- Preliminary results from a study show a significant proportion of multiple sclerosis patients have a narrowing of the veins that drain blood from the brain, a condition that's been suggested as a possible risk factor for the debilitating neurological disease.

The study by researchers at the University of Buffalo is being conducted to test a controversial hypothesis by Italian Dr. Paulo Zamboni that "chronic cerebrospinal venous insufficiency," or CCSVI, is an underlying cause of MS.

Zamboni, a professor of medicine at the University of Ferrara, has suggested restricted blood flow could damage brain tissue and may be one cause of MS. In experimental surgery dubbed the "liberation procedure," he has used balloon angioplasty to clear blockages in the veins of 65 patients.

While his theory flies in the face of the belief MS is an autoimmune disease, in which immune cells attack the myelin sheath around nerve cells, some doctors believe it should be investigated.

Dr. Robert Zivadinov, principal investigator of the University of Buffalo study, said he's "cautiously optimistic and excited" about the results.

Using Doppler ultrasound imaging on 500 people, the scientists found about 55 per cent of those diagnosed with MS had narrowing of the extracranial veins, compared to 22 per cent of healthy subjects. When the researchers excluded 10 per cent of subjects whose results were considered borderline, the proportion of MS patients with the venous abnormality rose to 62.5 per cent, and the proportion of controls to 26 per cent.

The researchers also found fewer cases of CCSVI in patients who had experienced a single MS attack, called clinically isolated syndrome, compared to those with more advanced symptoms of the disease -- 38 per cent versus 80 per cent.

Zivadinov, head of the Buffalo Neuroimaging Analysis Center at Buffalo General Hospital, said this suggests CCSVI could be linked to progression of MS. But he conceded his data do not offer proof of progression because the study looked at individual patients at only one point in time. A subsequent study is planned that would follow patients over time to see if venous insufficiency advances as their disease worsens.

"Don't underestimate these findings," Zivadinov said. "There is more to this story."

Since news of Zamboni's theory began making headlines late last year, people with MS have been clamouring to get into studies and demanded that research into CCSVI be expanded.

Toronto neurologist Dr. Paul O'Connor, a spokesman for the MS Society of Canada, said the organization decided to fund research on CCSVI after being inundated with thousands of requests from patients desperate for more effective treatments.

An estimated 55,000 to 75,000 Canadians have MS. In Manitoba, there are about 3,000 sufferers. Manitoba is considered an MS hot spot and has one of the highest rates of the disease in the country.

-- The Canadian Press, with staff file

Republished from the Winnipeg Free Press print edition February 11, 2010 A2

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