Venous Problems Not Linked With Multiple Sclerosis, Study Finds

New research provides evidence that reinforces skepticism about the idea that venous problems contribute to multiple sclerosis, a disease characterized by the demyelination of the nerves. (Image: JAMA, ©AMA)

A new imaging study has found no link between venous abnormalities in the central nervous system and multiple sclerosis (MS). The findings, which were published in the journal Radiology, add to a growing body of evidence suggesting that a risky surgical treatment targeting veins in the neck is unlikely to help patients with the disorder.

The experimental surgical procedure has become sought by some MS patients wanting relief from the effects of the neurodegenerative disorder. The rationale for the surgery derives from a hypothesis (advanced by scientist Paolo Zamboni, MD, of the University of Ferrara in Italy) that patients with MS have chronic cerebrospinal venous insufficiency (CCSVI), a narrowing of certain veins in the neck and chest that are purported to cause or contribute to the progression of MS by compromising blood drainage from the brain and upper spinal cord, leading to a build-up of iron and inflammation in the central nervous system. But there has been growing concern about the risks associated with the procedure, as well as the lack of strong evidence supporting its benefits. Earlier this year, the US Food and Drug Administration warned patients that this unproven treatment has resulted in serious injuries and death.

The latest study was led by multi-institution team of researchers (not including Zamboni) from Rome. It used imaging technologies to assess cerebrospinal venous abnormalities and their consequences in 39 patients with MS (25 of whom were classified as having CCSVI and 14 who were not) and 26 healthy control subjects (14 classified as having CCSVI and 12 who were not). They found that there is not a statistically significant association between CCSVI and MS and no association between such venous abnormalities and neurologic function or disease progression in patients with MS.

The researchers said that results also raise questions about whether CCSVI is really a pathologic condition at all but cautioned that further studies of CCSVI with larger sample sizes are needed to confirm their results.



Categories: Multiple Sclerosis/ Demyelinating Disease, Neuroimaging, Neurology