Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis
Author Information
Author(s): Zamboni P, Galeotti R, Menegatti E, Malagoni A M, Tacconi G, Dall’Ara S, Bartolomei I, Salvi F
Primary Institution: Vascular Diseases Center, University of Ferrara
Hypothesis
Is there an association between chronic cerebrospinal venous insufficiency (CCSVI) and multiple sclerosis (MS)?
Conclusion
Chronic cerebrospinal venous insufficiency is strongly associated with multiple sclerosis, characterized by abnormal venous haemodynamics due to multiple venous strictures.
Supporting Evidence
- CDMS and TCCS-ECD venous outflow anomalies were dramatically associated with an odds ratio of 43.
- Venography demonstrated multiple severe extracranial stenosis in CDMS patients, not in controls.
- Different CCSVI patterns were significantly associated with different clinical courses of MS.
- The pressure gradient across venous stenoses was significantly higher in MS patients.
Takeaway
This study found that people with multiple sclerosis often have problems with their veins that drain blood from the brain, which might affect how their disease progresses.
Methodology
The study involved 65 patients with clinically defined multiple sclerosis and 235 controls, using a combination of ultrasound and selective venography to assess venous outflow.
Potential Biases
Potential bias due to the single team conducting the ultrasound assessments.
Limitations
The study's findings may be limited by the operator-dependency of ultrasound assessments and the lack of intraobserver and interobserver variability data.
Participant Demographics
The MS group included 35 relapsing-remitting, 20 secondary progressive, and 10 primary progressive patients, with a median age of 41 years.
Statistical Information
P-Value
p<0.0001
Confidence Interval
95% CI 29 to 65
Statistical Significance
p<0.0001
Digital Object Identifier (DOI)
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