As interest grows in the theories of Zamboni about Chronic Cerebro-Spinal Venous Insufficiency (CCSVI) as the cause of multiple sclerosis, new research is being funded and undertaken to investigate this intriguing hypothesis. Zamboni's original work showed that 100% of people with MS studied had CCSVI and none of the people without MS had it.
Buffalo researchers failed to confirm this, showing that 56% of people with MS had CCSVI, around a quarter of people without illness had the condition, and around 43% of people with other neurological disorders also had CCSVI. A new paper from German researchers challenges this hypothesis.
Accepted for publication in the Annals of Neurology but not yet published, this paper is very important in the world-wide debate about CCSVI for a number of reasons. The researchers have a strong track record of research and publication in venous blood drainage from the brain, including publications in Stroke and The Lancet. Because of their experience and expertise in the area, they were able to do additional ultrasound measurements to further highlight venous drainage issues in the brain.
The study's findings
Their findings were surprising. In 56 people with MS and 20 controls, they found no evidence of CCSVI in any subjects, with or without MS. The only difference they found was less of a fall in venous blood volume flow in people with MS when they adopted the upright position, suggesting some alteration in the dynamics of brain blood circulation caused by the disease.
They concluded that there should be no surgical intervention for CCSVI until more research has been done to clarify the condition. The study was not blinded, so that investigators knew which patients had MS and which ones did not, as was the case with Zamboni's study.
This latest research raises many questions about the possible role of CCSVI in MS. It is important to wait for further research in the area before reaching any conclusions about whether CCSVI plays a role in MS or whether angioplasty or other treatment for CCSVI in MS can be recommended.