title: Multiple sclerosis and CCSVI: a population-based case control study.
abstract: BACKGROUND
  Chronic cerebrospinal venous insufficiency (CCSVI) has been associated to multiple sclerosis (MS).
  
  
  OBJECTIVE
  To evaluate the possible association between CCSVI and MS, using a population-based control design.
  
  
  METHODS
  A random cohort of 148 incident MS patients were enrolled in the study. We have also studied 20 patients with clinically isolated syndrome (CIS), 40 patients with other neurological diseases (OND), and 172 healthy controls. Transcranial (TCC) and Echo Color Doppler (ECD) were carried out in 380 subjects. A subject was considered CCSVI positive if ≥2 venous hemodynamic criteria were fulfilled.
  
  
  RESULTS
  CCSVI was present in 28 (18.9%) of the MS patients, in 2 (10%) of CIS patients, in 11 (6.4%) of the controls, and in 2 (5%) of the OND patients. A significant association between MS and CCSVI was found with an odds ratio of 3.41 (95% confidence interval 1.63-7.13; p = 0.001). CCSVI was significantly more frequent among MS subjects with a disease duration longer than 144 months (26.1% versus 12.6% of patients with duration shorter than 144 months; p = 0.03) and among patients with secondary progressive (SP) and primary progressive (PP) forms (30.2% and 29.4, respectively) than in patients with relapsing remitting (RR) MS (14.3%). A stronger association was found considering SP and PP forms (age adjusted OR = 4.7; 95% CI 1.83-12.0, p = 0.001); the association was weaker with the RR patients (age adjusted OR = 2.58; 95%CI 1.12-5.92; p = 0.02) or not significant in CIS group (age adjusted OR = 2.04; 95%CI 0.40-10.3; p = 0.4).
  
  
  CONCLUSIONS
  A higher frequency of CCSVI has been found in MS patients; it was more evident in patients with advanced MS, suggesting that CCSVI could be related to MS disability.
authors.affiliation: Department DANA GF Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Patti
authors.forename: Alessandra
authors.initials: A
authors.lastname: Nicoletti
authors.forename: Carmela
authors.initials: C
authors.lastname: Leone
authors.forename: Silvia
authors.initials: S
authors.lastname: Messina
authors.forename: Emanuele
authors.initials: E
authors.lastname: D'Amico
authors.forename: Salvatore
authors.initials: S
authors.lastname: Lo Fermo
authors.forename: Vincenza
authors.initials: V
authors.lastname: Paradisi
authors.forename: Elisa
authors.initials: E
authors.lastname: Bruno
authors.forename: Graziella
authors.initials: G
authors.lastname: Quattrocchi
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Veroux
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Pino
authors.forename: Luca
authors.initials: L
authors.lastname: Costanzo
authors.forename: Mario
authors.initials: M
authors.lastname: Zappia
mesh_terms: D000328:Adult; D000368:Aged; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D013131:Spine; D018615:Ultrasonography, Doppler, Color; D017585:Ultrasonography, Doppler, Transcranial; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology