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agate
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Joined: 17 May 2006
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Location: Oregon
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 Posted: Tue Mar 26, 2013 6:14 pm Post subject: (AAN) Assessment of CCSVI in MS |
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Presented at the AAN annual conference in San Diego, March 16-23, 2013:
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[P05.177] An Assessment of Chronic Cerebrospinal Venous Insufficiency in MS
Robert Fox, Cleveland, OH, Leasa Baus, Cleveland, OH, Claudiu Diaconu, Cleveland, OH, Alia Grattan, Cleveland, OH, Diane Ivancic, Cleveland, OH, Soo-Hyun Kim, Cleveland, OH, Jar-Chi Lee, Cleveland, OH, Mei Lu, Cleveland, OH, Larry Raber, Cleveland, OH, Sneha Ramesh, Cleveland, OH, Alexander Rae-Grant, Cleveland, OH
OBJECTIVE:
To conduct an independent assessment of chronic cerebrospinal venous insufficiency (CCSVI) in MS.
BACKGROUND:
CCSVI is a hypothesis of MS pathogenesis related to venous outflow from the head, with conflicting results from different studies. Recent studies have found a very low prevalence of CCSVI, suggesting that those investigators were performing ultrasound assessments differently [from] the original reports.
DESIGN/METHODS:
After obtaining formal training in CCSVI ultrasound techniques, we performed ultrasound assessments on a group of 61 MS subjects (4 CIS, 28 RRMS, 19 SPMS, 10 PPMS; 42 females) and 20 non-MS controls (15 healthy and 5 other neurological diseases; 10 female). Ultrasonographers were blinded to diagnosis, and separate research staff positioned subjects prior to ultrasonographer arrival.
Assessments were performed using a Biosound MyLab25, equipped with Quality Doppler Profiles (QDP) technology, and traditional transcranial Doppler.
Two published interpretations of CCSVI Criteria were utilized: Narrow Criteria did not include either B-mode intraluminal abnormalities or QDP technology for deep cerebral vein reflux, while Broad Criteria included both of these.
RESULTS:
Using either Narrow Criteria or Broad Criteria, there were no significant differences between MS subjects and controls (p>0.5 for both comparisons). In both groups, there was a doubling of the proportion of subjects meeting CCSVI criteria when using the Broad Criteria.
CONCLUSIONS:
Using trained and blinded ultrasonographers and QDP technology, we observed no difference in the proportion of MS subjects meeting CCSVI criteria compared to non-MS controls. Different interpretations of CCSVI criteria altered the proportions of subjects meeting CCSVI criteria, highlighting the importance of criteria interpretations when comparing the prevalence of CCSVI between studies.
These observations do not support a significantly increased prevalence of CCSVI in MS and suggest against a pathogenic role of CCSVI in MS.
Supported by: Research grant from National MS Society (RC 1004-A-5).
Category - MS and Related Diseases: Clinical Science
Wednesday, March 20, 2013 2:00 PM
Session P05: Multiple Sclerosis: Treatment Mechanism of Ac |
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