Purpose: To investigate the relationship between chronic cerebrospinal venous insufficiency (CCSVI) and cerebral haemodynamic parameters and to disclose any possible involvement in the pathophysiology of multiple sclerosis (MS).
Materials and Methods: The diagnosis of CCSVI was assigned by using specific colour Doppler ultrasonographic criteria. Cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time were assessed with dynamic susceptibility contrast material-enhanced magnetic resonance imaging in normal-appearing white matter (NAWM) in 39 patients with MS. Of these, 25 had CCSVI and 14 did not. Twenty-six healthy control subjects were also evaluated, and of these, 14 had CCSVI and 12 did not.
Results: Individuals with CCSVI showed cerebral haemodynamic anomalies, such as decreased CBF and CBV, as compared with individuals without CCSVI, without any delay in mean transit time. No significant interaction between MS and CCSVI was found for any haemodynamic parameters. Furthermore, no correlations were found between CBV and CBF values in NAWM or for severity of disability in patients with MS. The MS group showed prolonged mean transit time in the periventricular NAWM, as compared with the control group, and positive correlation was found between mean transit time values and disability scales in patients with MS.
Conclusion: The data support a role of CCSVI in cerebral haemodynamic changes, such as a decrease of CBV and CBF, regardless of the presence of MS. CCSVI had no effect on neurologic function and disability progression in patients with MS.
This study looks at MSers and finds some with criteria compatible with the theory of CCSVI and some that do not. Likewise there are healthy individuals with CCSVI and some without. Where there is ultrasonic CCSVI there can be evidence of vascular changes using MRI. However again this study provides further evidence that there is no specificity of MS and CCSVI. The Zamboni idea that CCSVI is causal to MS remains on thin ice and evidence is stacking up against this.