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Dr. Paolo Zamboni: Chronic cerebrospinal venous insufficiency (CCSVI) and MS (Multiple Sclerosis)
November 22nd, 2009 | 
Author: Chronic cerebrospinal venous insufficiency (CCSVI) and MS
Overview and FAQ
November 2009
"As President and CEO of the MS Society, I am aware of the tremendous interest across Canada and around the world caused by the recent news coverage of the CCSVI study. Indeed I share your excitement and hope in the preliminary findings of this study. I also celebrate and respect the integrity of our research funding programs which will continue to ensure that the very best projects are selected and supported. For more detail on this process please link here."
Yves Savoie
President and chief executive officer
President, Ontario Division
Overview
Chronic cerebrospinal venous insufficiency (CCSVI) describes a hypothetical disruption of blood flow in which the venous system is not able to efficiently remove blood from the central nervous system resulting in increased pressure in the veins of the brain and spinal cord which in turn results in damage to these areas. Recent reports have revived the idea of an association between inadequate venous drainage and multiple sclerosis.
The MS Society of Canada is aware of recent reports on the subject of CCSVI that may open up new avenues of research including new therapies for MS. While the early data shows promise, it is important to acknowledge that the concepts surrounding CCSVI and multiple sclerosis are still relatively new and requires replication and validation in much larger, well-designed scientific studies before they can be accepted as established.
The MS Society of Canada is closely monitoring all research related to CCSVI and will post new information on www.mssociety.ca
FAQ
1. What is CCSVI?
Chronic cerebrospinal venous insufficiency (CCSVI) is a term used to describe a hypothetical situation in which the venous system is not able to efficiently remove blood from the central nervous system. It is stated that this is related to narrowing of small venous structures in the neck, chest and spine.
2. Why is there a sudden interest in CCSVI and MS?
Media attention and a few recent reports have revived speculation about a possible dysfunction of brain blood flow and/or drainage in individuals who have MS. In particular, one study involving 65 people with different types of MS compared with 235 people who were healthy or who had other neurological disorders, a robust relationship was found between having MS and signs of venous insufficiency – suggesting that blood drainage by veins may be impaired, contributing to nerve tissue damage. This study, by Paulo Zamboni, MD (University of Ferrara - Ferrara, Italy) and colleagues, was published in 2009. (J Neurology Neurosurgery Psychiatry. 2009 Apr; 80 (4): 392-9. Epub. 2008 Dec 5.)
The investigators called this venous obstruction “chronic cerebrospinal venous insufficiency” or CCSVI. The treatment status of the people with MS did not appear to influence whether they showed signs of CCSVI. The authors speculate that the abnormal venous drainage of blood back from the brain and spine might set off the inflammation and immune-mediated damage that is characteristic of MS.
3. Do these reports of a possible association between insufficient vein drainage and MS mean that MS is caused by venous insufficiency?
Not necessarily. Based on what has been published so far, we can only say that MS may occur in association with impaired venous drainage of the central nervous system. This impairment, if truly present, could cause MS but it is possible that it is incidental to the disease. More study is needed.
4. How has CCSVI been treated?
Researchers involved with CCSVI have used “balloons” to open up narrowed veins or inserted stents into veins to help keep them open. This work is at a very early stage and has been performed on only a very small number of patients. It requires passing a catheter (wire) through the veins to the area of venous narrowing so that it can be widened and is not without risk including the chance of bleeding or the formation of abnormal blood clots.
5. Will the treatment of CCSVI be useful for the various forms of MS?
Whether this type of treatment will be useful in any form of MS is currently unknown as research on this question is at a very early stage. Much more work needs to be done.
6. What is the MS Society’s position on CCSVI?
The MS Society of Canada believes that this topic opens up new avenues of research in MS including the possibility of new treatments. Although the early data are of great interest, it is important to acknowledge that the concept of CCSVI as a cause of MS and the use of stents or balloons to widen veins as treatments, are ideas that are far from being accepted by most researchers in the field. The early results need to be replicated and validated in much larger well-designed studies.
The MS Society of Canada is closely monitoring all research related to CCSVI and will post new information on www.mssociety.ca.
7. Does the MS Society currently fund research into CCSVI?
At the present time, the MS Society of Canada does not fund research into CCSVI but it is open to the possibility of funding appropriately designed studies that address this topic.
The MS Society of Canada welcomes research proposals from qualified investigators based in Canadian institutions whose research questions are relevant to multiple sclerosis. All proposals received are thoroughly evaluated by expert volunteer scientific peer review panels from major academic research institutions. Proposals are evaluated for their scientific merit and relevance to the field of MS. This same policy would apply to potential research projects on the topic of CCSVI and MS.
8. Does the MS Society recommend people travel to get potential treatments related to this new idea?
The MS Society believes that this is a question to be addressed by the individual to their neurologist/physician. It is noteworthy that the treatment ideas in question are very new and not scientifically established.
9. I have MS. Should I be tested for signs of CCSVI?
Please consult your neurologist/physician for medical advice on this topic.
Posted in Living with MS, MS Local Chapters | 
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Why is the Durham Region MS Society looking for you?
The Durham Region Chapter of the Multiple Sclerosis Society of Canada is currently recruiting for a Chair Person. The Chapter Chair is a member of the chapter executive team and is responsible for presiding at all meetings, oversees the general affairs of the Chapter and ensure all orders of the Board of Directors are carried out. Candidates should be members of the CCFC (or willing to obtain membership), have basic knowledge of board functions, excellent organizational skills, a sense of responsibility and bondable. To apply for this position and obtain further information, contact Debbie at (905) 683-0388 or by email at ms.durham@bellnet.ca
Posted in MS Local Chapters |
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Multiple Sclerosis Society of Canada – Durham Region Chapter
The Multiple Sclerosis society of Canada has many local chapters to assist at the community level. Just east of Toronto Ontario is the community of Durham Region consisting of Pickering, Ajax, Whitby, Oshawa, Uxbridge, Brock, Scugog and Clarington. Having a local chapter in the Durham Region helps those inflicted with Multiple Sclerosis as well supports their caregivers. If you are newly diagnosed and need information on Multiple Sclerosis and the various options available to you contact the staff at the MS Society Durham Chapter. They have a wealth of information that is designed to help you. Various events and fundraisers throughout the year help to raise funds that help both the local community and the fight to end MS.
If you are suffering from Multiple Sclerosis or know someone who is, contact you local Chapter In Durham Region and get involved.
You can contact the Multiple Sclerosis Durham Region Chapter directly at;
#6-400 Dundas St W
Whitby, ON L1N 2M7
Telephone : +1 (905) 668-0388,
Fax : +1 (905) 668-6904
ms.durham@bellnet.ca
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Tags: ajax, clarington, durham region, MS Durham Region, MS research, MS Society, multiple sclerosis, multiple sclerosis durham region, newly diagnosed, oshawa, Pickering, scugog, uxbridge, whitby |
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