The severity of chronic cerebrospinal venous insufficiency in patients with multiple sclerosis is related to altered cerebrospinal fluid dynamics.
Chronic cerebrospinal venous insufficiency (CCSVI) is a vascular picture that shows a strong association with multiple sclerosis (MS). The aim of this study was to investigate the relationship between a Doppler cerebral venous hemodynamic insufficiency severity score (VHISS) and cerebrospinal fluid (CSF) flow dynamics in 16 patients presenting with CCSVI and relapsing-remitting MS (CCSVI-MS) and in eight healthy controls (HCs). The two groups (patients and controls) were evaluated using validated echo-Doppler and advanced 3T-MRI CSF flow measures. Compared with the HCs, the CCSVI-MS patients showed a significantly lower net CSF flow (p=0.027) which was highly associated with the VHISS (r=0.8280, r2=0.6855; p=0.0001). This study demonstrates that venous outflow disturbances in the form of CCSVI significantly impact on CSF pathophysiology in patients with MS.
Zamboni
P
P
Vascular Diseases Center, University of Ferrera, and Bellaria Neurosciences, Ferrara and Bologna, Italy. zmp@unife.it
Menegatti
E
E
Weinstock-Guttman
B
B
Schirda
C
C
Cox
J L
JL
Malagoni
A M
AM
Hojanacki
D
D
Kennedy
C
C
Carl
E
E
Dwyer
M G
MG
Bergsland
N
N
Galeotti
R
R
Hussein
S
S
Bartolomei
I
I
Salvi
F
F
Zivadinov
R
R
D000328:Adult; D001921:Brain / Q000098:blood supply; D016022:Case-Control Studies; D002555:Cerebrospinal Fluid / Q000502:physiology*; D015170:Cerebrospinal Fluid Pressure; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000134:cerebrospinal fluid / Q000150:complications*; D002908:Chronic Disease; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016555:Matched-Pair Analysis; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000134:cerebrospinal fluid / Q000150:complications*; D010865:Pilot Projects; D012016:Reference Values; D012039:Regional Blood Flow; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013116:Spinal Cord / Q000098:blood supply; D018615:Ultrasonography, Doppler, Color; D017585:Ultrasonography, Doppler, Transcranial; D014689:Venous Insufficiency / Q000134:cerebrospinal fluid / Q000150:complications*