Recent reports from Italy that a correctible vascular condition may be the cause of MS, or contribute to its progression, have grabbed the attention of the MS community. However, many MS healthcare specialists are taking a “let’s wait and see” approach because the true significance of this research has yet to be determined.
A vein condition dubbed Chronic Cerebrospinal Venous Insufficiency (CCSVI) has been the focus of research led by Paolo Zamboni, M.D., a former vascular surgeon and professor at the University of Ferrara. Zamboni has discovered, using ultrasound, that almost all MS patients he viewed had blocked or twisted veins in their necks and upper chest. Healthy people do not typically have this condition.
In people with CCSVI, Dr. Zamboni theorizes, blood fails to properly drain from the brain and can even flow back upwards into the brain. There, the blood could be depositing iron, a substance that is toxic to the brain's grey matter. This excess iron could be what sets off a host of immune reactions -- and possibly, the symptoms of MS.
He has tested a procedure he calls the "Liberation Treatment" that he says can open those blocked veins using a balloon inserted in the vein, in much the way surgeons repair coronary arteries in angioplasty. The hope is that the treatment allows blood to drain properly and arrests the progression of MS.
While all preliminary research that leads to a better understanding of the cause and course of MS is interesting, people with MS should remember that much additional research and clinical trials are often needed to validate early findings, according to MSF Medical Advisor Ben Thrower, M.D.
"This is interesting research that needs to be looked at in a larger study," Dr. Thrower says. "I would urge caution in pursuing any type of vascular therapy until we have a little more data. It is possible that the findings of venous insufficiency are true for some people with MS, but that does not necessarily mean that the venous changes cause the MS lesions. Another problem with the venous theory is that it would not account for the presence of MS lesions in the spinal cord, outside of the brain."
Dr. Zamboni has begun publishing research on CCSVI, hoping to compel others doctors to take a look at his theory. His work caught the attention of Robert Zivadinov, M.D., at the University of Buffalo, who is also now conducting research on the prevalence of CCSVI.
The Buffalo team, led by Dr. Zivadinov, plans to recruit 1,100 patients with MS and 600 other volunteers as controls who are either healthy or have neurological diseases other than MS.Using Doppler ultrasound, they will scan the patients to see if they can find any blockages within the veins of the neck and brain.If they can prove Dr Zamboni's theory of "chronic cerebrospinal venous insufficiency", they say it will change our understanding of MS.