CCSVI and MS: no meaning, no fact.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
Claudio BaracchiniPaolo Gallo

Abstract

A condition called "chronic cerebrospinal venous insufficiency" (CCSVI) has been postulated to play a role in the pathogenesis of multiple sclerosis (MS). This hypothesis implies that a complex pattern of extracranial venous stenosis determines a venous reflux into the brain of MS patients, followed by increased intravenous pressure, blood-brain barrier breakdown and iron deposition into the brain parenchyma, thus triggering a local inflammatory response. In this review, we critically analyze the scientific basis of CCSVI, the current literature on the relationship between CCSVI and MS, as well as the ultrasound methodology that has been claimed to provide evidence of impaired cerebral venous drainage. We show that no piece of the CCSVI theory has a solid supportive scientific evidence. The CCSVI appears to be a rather alien condition and its existence should be definitely questioned. Finally, no proven (i.e., based on strict scientific methodology and on the rules of evidence-based medicine) therapeutic effect of the "liberation" procedure (unblocking the extracranial venous obstruction using angioplasty) has been shown up to date.

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Citations

May 22, 2013·Multiple Sclerosis International·Bernhard H J Juurlink
Feb 8, 2014·Cellular and Molecular Life Sciences : CMLS·Vladimir V Bamm, George Harauz
Jan 29, 2013·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·A GhezziUNKNOWN MS Study Group-Italian Society of Neurology
Apr 13, 2013·Journal of the Neurological Sciences·Fred D Lublin
Feb 20, 2013·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·W Pryse-PhillipsB Barrett
Nov 12, 2013·Journal of Magnetic Resonance Imaging : JMRI·Clive B BeggsRobert Zivadinov

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