title: Hydration status substantially affects chronic cerebrospinal venous insufficiency assessments.
abstract: We sought to determine the effect of hydration on the criteria for chronic cerebrospinal venous insufficiency (CCSVI), a proposed hypothesis for the etiology of multiple sclerosis (MS). Sixteen subjects (11 MS and 5 controls) were asked to fast overnight. The following morning, 2 CCSVI ultrasound examinations were performed: 1 in the mildly dehydrated state, and another 30-45 minutes after rehydrating with 1.5 L of Gatorade. Seven subjects fulfilled CCSVI criteria in the dehydrated state. Of these, 5 (71%) no longer fulfilled CCSVI criteria after rehydration. One additional subject met CCSVI criteria only after rehydration. Hydration status has a substantial effect on CCSVI criteria, suggesting that the sonographic findings of CCSVI may represent a physiologic rather than pathologic state.
authors.affiliation: Cleveland Clinic Lerner College of Medicine of Case Western Reserve University (CID), Mellen Center for Multiple Sclerosis Treatment and Research (RJF, AR-G), Heart and Vascular Institute, Cardiovascular Medicine, Non-Invasive Vascular Laboratory (AG, HLG, ESHK), and Neurological Institute, Cerebrovascular Center (ML), Cleveland Clinic, Cleveland, OH.
authors.forename: Claudiu I
authors.initials: CI
authors.lastname: Diaconu
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Fox
authors.forename: Alia
authors.initials: A
authors.lastname: Grattan
authors.forename: Alexander
authors.initials: A
authors.lastname: Rae-Grant
authors.forename: Mei
authors.initials: M
authors.lastname: Lu
authors.forename: Heather L
authors.initials: HL
authors.lastname: Gornik
authors.forename: Esther Soo H
authors.initials: ES
authors.lastname: Kim