TY - JOUR
T1 - Chronic cerebrospinal venous insufficiency in multiple sclerosis
T2 - Clinical correlates from a multicentre study
AU - Bastianello, Stefano
AU - Romani, Alfredo
AU - Viselner, Gisela
AU - Tibaldi, Enrico C.
AU - Giugni, Elisabetta
AU - Altieri, Marta
AU - Cecconi, Pietro
AU - Mendozzi, Laura
AU - Farina, Massimiliano
AU - Mariani, Donatella
AU - Galassi, Antonio
AU - Quattrini, Claudio
AU - Mancini, Marcello
AU - Bresciamorra, Vincenzo
AU - Lagace, Angela
AU - McDonald, Sandy
AU - Bono, Giorgio
AU - Bergamaschi, Roberto
PY - 2011/10/26
Y1 - 2011/10/26
N2 - Background: Chronic cerebrospinal venous insufficiency (CCSVI) has recently been reported to be associated with multiple sclerosis (MS). However, its actual prevalence, possible association with specific MS phenotypes, and potential pathophysiological role are debated.Method: We analysed the clinical data of 710 MS patients attending six centres (five Italian and one Canadian). All were submitted to venous Doppler sonography and diagnosed as having or not having CCSVI according to the criteria of Zamboni et al.Results: Overall, CCSVI was diagnosed in 86% of the patients, but the frequency varied greatly between the centres. Even greater differences were found when considering singly the five diagnostic criteria proposed by Zamboni et al. Despite these differences, significant associations with clinical data were found, the most striking being age at disease onset (about five years greater in CCSVI-positive patients) and clinical severity (mean EDSS score about one point higher in CCSVI-positive patients). Patients with progressive MS were more likely to have CCSVI than those with relapsing-remitting MS.Conclusion: The methods for diagnosing CCSVI need to be refined, as the between-centre differences, particularly in single criteria, were excessively high. Despite these discrepancies, the strong associations between CCSVI and MS phenotype suggest that the presence of CCSVI may favour a later development of MS in patients with a lower susceptibility to autoimmune diseases and may increase its severity.
AB - Background: Chronic cerebrospinal venous insufficiency (CCSVI) has recently been reported to be associated with multiple sclerosis (MS). However, its actual prevalence, possible association with specific MS phenotypes, and potential pathophysiological role are debated.Method: We analysed the clinical data of 710 MS patients attending six centres (five Italian and one Canadian). All were submitted to venous Doppler sonography and diagnosed as having or not having CCSVI according to the criteria of Zamboni et al.Results: Overall, CCSVI was diagnosed in 86% of the patients, but the frequency varied greatly between the centres. Even greater differences were found when considering singly the five diagnostic criteria proposed by Zamboni et al. Despite these differences, significant associations with clinical data were found, the most striking being age at disease onset (about five years greater in CCSVI-positive patients) and clinical severity (mean EDSS score about one point higher in CCSVI-positive patients). Patients with progressive MS were more likely to have CCSVI than those with relapsing-remitting MS.Conclusion: The methods for diagnosing CCSVI need to be refined, as the between-centre differences, particularly in single criteria, were excessively high. Despite these discrepancies, the strong associations between CCSVI and MS phenotype suggest that the presence of CCSVI may favour a later development of MS in patients with a lower susceptibility to autoimmune diseases and may increase its severity.
UR - http://www.scopus.com/inward/record.url?scp=81455142486&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=81455142486&partnerID=8YFLogxK
U2 - 10.1186/1471-2377-11-132
DO - 10.1186/1471-2377-11-132
M3 - Article
C2 - 22029656
AN - SCOPUS:81455142486
VL - 11
JO - BMC Neurology
JF - BMC Neurology
SN - 1471-2377
M1 - 132
ER -