CCSVI: PAST, PRESENT AND FUTURE

The past and recent press exposure for Paolo Zamboni's research into the vascular nature of multiple sclerosis (MS) has generated an unprecedented interest by MS patients around the world. Imaging sites have been inundated with 10,000s of patients seeking answers and contacts. Each site has made an effort to answer each of you individually but this been a drain on everyone's resources. We request that you please review the information below and contact your own doctor and neurologist at this time. Although there are ultrasound and MR imaging methods available to study the body's vasculature, the ability to study this new concept in a coherent fashion will take a lot of important and careful research. Many sites are in the process of getting approval from their local institutional review board (IRB) also known as an independent ethics committee (IEC) or research ethics board (REB). These are committees that have been formally designated to approve, monitor, and review biomedical and behavioral research involving humans with the aim to protect the rights and welfare of the research subjects. The research community is doing its best to respond to this new challenge. We will try and keep everyone apprised of the current situation from whatever public information is available at this site. Please be aware that this site does not solicit volunteers for research. Finally, please be patient as the scientific approach must take its course for the benefit and protection of all concerned.


The IDEA behind CCSVI

The following is an opinion based on material available in the public domain:

"In the last few years, researchers have recognized the presence of increased iron content in the basal ganglia and thalamus. This in itself suggests the possibility of venous damage in MS. But the interest and association of MS with veins dates back to Putnam (1) in the 1930s (and much earlier than this as well) and then later to Fog (2) in 1964 followed by a major decade's long effort to convince people of the role of the mechanical effects of changes in venous flow by Schelling (3). It is interesting to note that a similar discovery of the role of the vena caval system was made in the early 1970s by Aboulker et al (4) where he found that angioplasty helped many of the paraplegic and quadraplegic patients he dealt with. More recent evidence by Paolo Zamboni and his team (5) suggests that MS is strongly associated with a chronic cerebral spinal venous insufficiency (CCSVI). It may be that changes in shear stress can cause a biological response that is very similar to what we see in MS (see, for example, the work by John Bergan (6)). In fact, it is a logical explanation as to why the entire brain is affected in MS, why the disease tracks backward along the venous drainage system, and why it emanates from the white matter near the ventricles in the drainage territory of the medullary veins. Our own work has shown that iron builds up in the basal ganglia and pulvinar thalamus in MS patients (7,8)."

For a review of the role of venous abnormalities in neurodegenerative diseases see ref. (9-12).
E. Mark Haacke