title: Chronic cerebrospinal venous insufficiency in multiple sclerosis: a highly prevalent age-dependent phenomenon.
abstract: BACKGROUND
  This study aimed to investigate the prevalence and clinical relevance of chronic cerebrospinal venous insufficiency (CCSVI) in multiple sclerosis (MS) patients and healthy controls using extra- and intracranial colour Doppler sonography.
  
  
  METHODS
  We examined 146 MS patients, presenting with a clinically isolated syndrome, relapsing-remitting, secondary progressive, or primary progressive MS, and 38 healthy controls. Sonographic examination was performed according to Zamboni's protocol and was performed by three independent sonographers. The results of sonographic examination were compared with clinical and demographic characteristics of the patients.
  
  
  RESULTS
  CCSVI, defined as the presence of at least two positive Zamboni's criteria, was found in 76% of MS patients and 16% of control subjects. B-mode anomalies of internal jugular veins, such as stenosis, malformed valves, annuli, and septa were the most common lesions detected in MS patients (80.8%) and controls (47.4%). We observed a positive correlation between sonographic diagnosis of CCSVI and the patients' age (p = 0.003). However, such a correlation was not found in controls (p = 0.635). Notably, no significant correlations were found between sonographic signs of CCSVI and clinical characteristics of MS, except for absent flow in the jugular veins, which was found more often in primary (p<0.005) and secondary (p<0.05) progressive patients compared with non-progressive patients. Absent flow in jugular veins was significantly correlated with patients' age (p < 0.0001).
  
  
  CONCLUSIONS
  Sonographically defined CCSVI is common in MS patients. However, CCSVI appears to be primarily associated with the patient's age, and poorly correlated with the clinical course of the disease.
authors: Department of Neurological Sciences, Federico II University School of Medicine, Naples, Italy.
authors: Roberta
authors: R
authors: Lanzillo
authors: Marcello
authors: M
authors: Mancini
authors: Raffaele
authors: R
authors: Liuzzi
authors: Orlando
authors: O
authors: Di Donato
authors: Elena
authors: E
authors: Salvatore
authors: Valentina
authors: V
authors: Maglio
authors: Giovanni
authors: G
authors: Vacca
authors: Luca
authors: L
authors: Amato
authors: Gennaro
authors: G
authors: D'Anna
authors: Arturo
authors: A
authors: Brunetti
authors: Vincenzo
authors: V
authors: Brescia Morra
mesh_terms: D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D018615:Ultrasonography, Doppler, Color; D014689:Venous Insufficiency / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*