An abnormal narrowing or obstruction in blood vessels that carries blood away from
the brain possibly causing a build up of iron, and inflammation and damage to cells
in the central nervous system.
A chronic (ongoing) problem where blood from the brain and spine has trouble getting
back to the heart. It’s caused by stenosis (a narrowing) in the veins that drain
the spine and brain. Blood takes longer to get back to the heart, and it can reflux
back into the brain and spine or cause oedema and leakage of red blood cells and
fluids into the delicate tissue of the brain and spine.
Blood that stays in the brain too long creates ‘slowed perfusion’ - a delay in deoxygenated
blood leaving the head. This can cause a lack of oxygen (hypoxia) in the brain. Plasma
and iron from blood deposited in the brain tissue are also very damaging.
This narrowing restricts the normal outflow of blood from the brain. As a result,
the blood often ‘refluxes’ that is: it flows backwards into the brain. Some think
the resulting flow and building pressure pushes blood into the tissue around vessels
in the brain, resulting in toxic iron deposits that some believe may trigger inflammation,
injury to brain tissue and cell death.
The hypothesis of the relation between Chronic cerebrospinal venous insufficiency
(CCSVI) and multiple sclerosis (MS). The pattern of CCSVI was described by Prof.
Zamboni.
Prof. Mark Haacke, the director of the Magnetic Resonance Imaging Institute for Biomedical
Research at Wayne State University in Detroit, is also conducting his own study.
He's a physicist who also works at McMaster University in Hamilton, who has invented
a novel tool used to analyze MRI scans of the brain called SWI, "susceptibility weighted
imaging system." SWI is highly sensitive to the presence of substances such as iron
and is considered one of the most sophisticated and advanced system for the diagnosis
of MS.
Prof. Haacke is a physicist; his interest is confirming Dr. Zamboni's theory. He
does not treat people. Haacke's team can be contacted at info.mrimaging@gmail.com
Dr. Zamboni's team at the University of Ferrara and the Santa Anna Hospital in Ferrara
can be contacted at centroilbene@gmail.com
Research - A small study was published in April 2009 which found that CCSVI occurred
in more than 90% of the 65 MS people in the study group but not within the control
group of both healthy people and other people with other neurological conditions.
Preliminary results from a study at the University of Buffalo were made available
in February 2010. The first phase of this study scanned 500 people of which 280 suffered
with MS, 59 with clinically isolated syndrome (CIS) and other neurological Conditions,
and 161 healthy controls.
The study reported that the level of CCSVI amongst those with MS was 56.4% and amongst
non MS people 22.4%.
A further phase involving another 500 people is planned and the full results from
the first phase will be reported at the American Academy of Neurology meeting in
April. Dr Robert Zivadinov, the principal investigator on the study, said, "The data
show that narrowing of the extracranial veins, at the very least may be an important
association in multiple sclerosis."
He also noted that the findings amongst the 22.4% of non MS people where ccsvi was
occurring also met two of the CCSVI criteria and requires continuing investigation.
Treatment - Prof Zamboni has proposed that the blockage in blood vessels can be removed
with surgery, sometimes called the 'liberation procedure'. A paper published by him
in December 2009 reports that amongst 35 those with relapsing remitting MS, 50% had
no relapses in the year following surgery, compared to 27% in the period before undergoing
the procedure.
Note - Participants remained on chronic condition modifying treatments during this
period.
Results from 30 those with progressive forms of MS showed no significant change in
assessments of cognitive and motor function using the Multiple Sclerosis Functional
Composite scale. In February 2010, the journal Annals of Neurology reported that
treatment at Stanford Medical Centre had been suspended after two those who had undergone
stenting of the jugular veins developed serious complications.
Further studies - At a meeting in Canada in February 2010, Prof Zamboni reiterated
that he doesn't suggest that blockages are the only cause of multiple sclerosis and
he called for more rigorous testing of his work. Further studies of CCSVI and MS
are planned. Reports from some of the those who have had the procedure suggest that
it may not permanently cure the blockage and that the condition can reoccur.
Zamboni P, et al. Chronic cerebrospinal venous insufficiency in people with multiple
sclerosis. Journal of Neurology, Neurosurgery & Psychiatry 2009;80(4):392-399. Pub
Med Internet Page
First blinded study of venous insufficiency prevalence in MS shows promising results.
University of Buffalo press release - 10 February 2010. Internet Page
Zamboni et al. A prospective open-label study of endovascular treatment of chronic
cerebrospinal venous insufficiency. journal of Vascular Surgery 2009;50:1348-1358.
Pub Med Internet Page
Catalyst For Change -CCSVI is dominating the MS news these days and that is not
all bad. For one thing, Dr. Zamboni's treatment might very well help many those who
are currently suffering the effects of Multiple Sclerosis. These people have experienced
little or no relief from current mainstream treatments and their health is declining
more with each passing year. They are desperate and they are not afraid to admit
it. They are being told to wait 5 years or more for "official" results to confirm
or deny that CCSVI is a valid treatment and they counter back (rightly so) that they
don't have 5 years to wait - MS is a progressive chronic condition; they need help
NOW.
This, to me, is the real benefit of CCSVI; it has become the catalyst for change
that we have so desperately needed within the MS community AND throughout the whole
health care and treatment arena. We are finally starting to think - and LOOK - outside
the box and we are finally questioning long standing dogma about MS and its treatment.
What I find disturbing, however, is that so many of today's "new" discoveries - CCSVI
included - are not new at all. Dr. Zamboni stated in his initial interviews that
his discovery of CCSVI as a possible area for treatment was a product of his search
through the MS archives from decades past. What he discovered was that damaged veins
have been a hallmark of the chronic condition and discussed in medical literature
dating back to the 1860's. This led to his own discoveries that CCSVI did appear
to be prevalent in MS cases such as his wife's and sparked an explosion in research
into this new area.
Other Examples of Ignored Research -There are other examples of important scientific
research, ranging back over the past 100 years and more, that are being studiously
ignored. We all know the story of Pulitzer prize winner Dr. Barry Marshall's 20 year
odyssey to gain acceptance for his work proving that H. pylori is the predominant
underlying cause of stomach ulcers. How many those are aware that Dr. Marshall was
NOT the first to make this discovery?
In 1874, Arthur Boettcher MD published a paper on a small, curved bacterium that
he found repeatedly in stomach ulcers. Dr. Boettcher's work was confirmed by his
peers and ulcer people were successfully treated with antibiotics until around 1950
when this important work just vanished from medical text books and practices. Why?!!?
Gabriel Steiner MD, another pioneer in microbiology from the first half of the 20th
Century, studied MS extensively and was convinced that a spirochete, which he unofficially
named Borrelia Myelophthora, was the underlying cause of the myelin damage documented
in MS autopsies. He developed the "Steiner Silver Stain" which distinctly showed
these bacteria and their "fragments" (which later proved to be the cyst form of the
bacteria) in sharp detail in microscopy. More recent research has consistently found
the cyst forms of spirochetes in the CSF of MS people and yet this research is totally
ignored. Why?!!? Strong parallels among Syphilis, Relapsing Fever, Lyme chronic condition
and MS exist. Vascular involvement with IRON DEPOSITS are well documented in Syphilis,
and yet nobody seems to think that this is relevant to current MS research. Why?!!?
My personal view is that CCSVI is not the cause of MS but, like lesions, is a symptom
of the chronic condition; one that, if corrected, might make a significant difference
in quality of life for those with MS and might even impact chronic condition progression.
Imagine this scenario: a person with diabetes gets a gangrenous toe because of poor
circulation and the health professional says, "Gangrene doesn't cause diabetes. What
makes you think that treating that toe is going to make you better?" An unlikely
scenario because the medical community accepts that poor circulation IS an important
concern in diabetes cases and that, while getting rid of the gangrene isn't going
to cure diabetes, it will go a long way toward preserving the overall health of the
person.
CCSVI might be completely unrelated to MS but that does not preclude its impact on
a person's overall health. Improving circulation is by and large an important factor
in maintaining a healthy body. Instead of arguing about its status as either cure
or treatment, we should be evaluating each person for ANY systems that are below
clinical standards and trying to help these those return to as normal a physical
state as possible.
In parallel with this clinical support, we MUST continue to look "outside the box"
to uncover the underlying cause(s) of these dysfunctions or we are forever doomed
to fighting fires set by an anonymous and unchallenged arsonist.
Dr. Zamboni has thrown a rock that has broken a window and let in some much needed
fresh air and light into the stagnant global mindset of MS as an autoimmune chronic
condition. Let us take advantage of the current momentum and continue to push forward,
leaving no stone unturned, until we find the answers we need to fix the problem we
now call MS - not just mask it with expensive band-aids!
