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Posted by on Oct 27, 2011 in Media, Neurology, Neuropsychiatry

Another Study Contradicts Venous Insufficiency in Multiple Sclerosis

Another Study Contradicts Venous Insufficiency in Multiple Sclerosis

Neck_veins_Grays.gifFrom this week’s issue of Neurology.

Using MR venography and ultrasound* in 40 patients with MS, German investigators failed to replicate the 100% prevalence of chronic cerebrospinal venous insufficiency (CCSVI) defined famously (and notoriously) by Zamboni et al in 2009 (for background, start here or search Pathophilia for “Zamboni”). This newly published study, by the authors’ account, is at least the 13th study** that has failed to validate Zamboni’s theory of venous insufficiency in MS and his follow-up idea that the stenting of cerebral veins (ostensibly to improve the egress of iron) could be somehow objectively clinically beneficial.

Here’s the parade of negative studies cited by the German authors (Doepp et al); 11 of these studies have been published in English-language peer-reviewed journals (all of which are reasonably well regarded).

Ultrasound studies

MR angiography

Selective venography

Measurement of intraocular venous pressure

Measurement of CSF ferritin levels

* Specifically dynamic extracranial color-coded duplex sonography (ECCS).
** The cited studies do not include the essentially negative ultrasound study from the University of Buffalo, which was recently published in April in Neurology. Consequently the peer-reviewed tally comes to 14 negative studies.

Image of neck veins from Gray’s Anatomy (1918).

bmartin (1127 Posts)

A native East Tennessean, Barbara Martin is a formerly practicing, board-certified neurologist who received her BS (psychology, summa cum laude) and MD from Duke University before completing her postgraduate training (internship, residency, fellowship) at the Hospital of the University of Pennsylvania in Philadelphia. She has worked in academia, private practice, medical publishing, drug market research, and continuing medical education (CME). For the last 3 years, she has worked in a freelance capacity as a medical writer, analyst, and consultant. Follow Dr. Barbara Martin on and Twitter.