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Rivista di Angiologia
Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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International Angiology 2010 April;29(2):140-8
CSF dynamics and brain volume in multiple sclerosis are associated with extracranial venous flow anomalies: a pilot study
Zamboni P. 1, Menegatti E. 1, Weinstock-Guttman B. 2, Schirda C. 3, Cox J. L. 3, Malagoni A. M. 1, Hojnacki D. 2, Kennedy C. 3, Carl E. 3, Dwyer M. G. 3, Bergsland N. 3, Galeotti R. 1, Hussein S. 3, Bartolomei I. 1, Salvi F. 1, Ramanathan M. 2,4 Zivadinov R.2,3 ✉
1 Vascular Diseases Center, University of Ferrara-Bellaria Neurosciences, Ferrara and Bologna, Italy;
2 The Jacobs Neurological Institute, State University of New York, NY, USA;
3 Buffalo Neuroimaging Analysis Center, State University of New York, NY, USA;
4 Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
AIM: We previously reported unexpectedly robust associations between vascular haemodynamic (VH) anomalies in the principal extracranial cerebral veins, causing chronic cerebrospinal venous insufficiency (CCSVI), and multiple sclerosis (MS). Aim of this study was to investigate the relationship between the VH changes and MRI measures of MS disease severity in a cross sectional survey.
METHODS: The number of anomalous VH criteria were measured using an echo-color Doppler, whereas CSF flow, atrophy and lesion measures were obtained from quantitative magnetic resonance imaging (MRI) analysis in sixteen consecutive relapsing-remitting MS patients, (mean age: 36.1±SD 7.3 years, disease duration: 7.5±1.9 years and median EDSS: 2.5) and in 8 healthy controls (HC) with similar age and sex distributions.
RESULTS: All 16 MS patients investigated and none of the HCs met the VH criteria for CCSVI (P<0.0001). MS patients showed significantly lower net CSF flow compared to the HC (P=0.038) that was associated with number of anomalous VH criteria present (r=0.79, P<0.001). Moreover, increases in the number of anomalous VH criteria present were negatively associated with lower whole brain volume (Spearman R=-0.5, P=0.05).
CONCLUSION: VH changes occur more frequently in MS patients than controls. Altered VH is associated with abnormal CSF flow dynamics and decreased brain volume.