"Negative study" from Germany, UK and PDFs for Int Angiol. 2010 Apr;29(2) available

Navigation

Upgrade tasks

Check upgrade status
Update modules
Enable maintenance mode
Verify maintenance theme
Verify access to update.php
Disable non-core modules
Verify default theme
Backup current site
Replace Drupal core
Run update.php for core
Download new project versions
Backup current site
Run update.php for modules
Re-enable modules
Check status report

Last modified: 15.06.2010 - 18:55 CET Created: 15.06.2010 - simplex

PDFs are available for free of the Int Angiol. 2010 Apr;29(2) issue. Check out the previous article.
[doepp10a] Doepp F, Paul F, Valdueza JM, Schmierer K, Schreiber SJ: No cerebro-cervical venous congestion in patients with multiple sclerosis. Annals of Neurology. 2010. doi:10.1002/ana.22085. Article$
Department of Neurology, University Hospital Charité, Humboldt University, Berlin, Germany; Barts and The London Queen Mary School of Medicine & Dentistry, London, UK

Abstract
Objective:
Multiple sclerosis (MS) is characterized by demyelination centered around cerebral veins. Recent studies suggested this topographic pattern may be caused by venous congestion, a condition termed chronic cerebro-spinal venous insufficiency (CCSVI). Published sonographic criteria of CCSVI include reflux in the deep cerebral veins and/or the internal jugular and vertebral veins (IJVs and VVs), stenosis of the IJVs, missing flow in IJVs and VVs, and inverse postural response of the cerebral venous drainage.

Methods:
We performed an extended extra- and transcranial color-coded sonography study including analysis of extracranial venous blood volume flow (BVF), cross-sectional areas, IJV flow analysis during valsalva manoever (VM) as well as CCSVI criteria. 56 MS patients and 20 controls were studied.

Results:
Except for one patient, blood flow direction in the IJVs and VVs was normal in all subjects. In none of the subjects was IJV stenosis detected. IJV and VV BVF in both groups were equal in the supine body position. The decrease of total jugular BVF upon turning into the upright position was less pronounced in patients (173±235 vs 362±150 ml/min, p<0.001), leading to higher BVF in the latter position (318 ml/min±242 vs 123±109 ml/min; p<0.001). No differences between groups were seen in intracranial veins and during VM. None of the subjects investigated in this study fulfilled more than one criterion for CCSVI.</p>
Interpretation:
Our results challenge the hypothesis that cerebral venous congestion plays a significant role in the pathogenesis of MS. Future studies should elucidate the difference between patients and healthy subjects in BVF regulation.