UBC and Vancouver Coastal Health are leading two studies exploring the theory of chronic cerebrospinal venous insufficiency (CCSVI) — a hypothesis that a blockage of veins in the head and neck results in excessive brain iron and contributes to multiple sclerosis. These studies aim to provide evidence that can concretely move forward the discussion on CCSVI and MS, as well as potential treatment.
One study, led by Anthony Traboulsee, an Associate Professor of Neurology and Medical Director of the UBC Hospital MS Clinic of Vancouver Coastal Health, will seek to verify the condition itself using catheter venography, the most accurate, “gold-standard” technology to image veins. The study, in collaboration with the University of Saskatchewan, also will examine the usefulness of ultrasound to screen for CCSVI.
The other study, also led by Dr. Traboulsee, is examining the efficacy of angioplasty to treat people with MS. About 100 patients will be randomized to receive venoplasty treatment (interventional radiology treatment using a balloon) or a sham treatment and cross over to the other treatment at year one, so all patients will receive the venoplasty at some point.
[ For specific information about this trial, please visit this page of the Vancouver Coastal Health Research Institute.]
The imaging study recruited 100 MS and 100 non-MS subjects from existing patient rosters at the MS Clinic at UBC Hospital and the Saskatoon MS Clinic. Letters of invitation were sent to all potentially eligible subjects identified from these rosters by the research team, and included subjects with twins or family members with confirmed MS. This group of subjects will allow the verification of the condition of CCSVI and determine if there is a genetic (inherited) link to this condition.
Background on CCSVI and multiple sclerosis
Multiple sclerosis is the leading cause of disability in Canada. Over 60,000 Canadians are affected by this disease. The cause of MS is unknown but likely the interaction between genes and the environment play an important role. It is a disease that randomly attacks the myelin coating of nerves in the brain, optic nerves and spinal cord.
Chronic cerebrospinal venous insufficiency (CCSVI) is a hypothesis that the large veins that drain the blood from the brain and spinal cord appear to be narrowed in MS patients compared to people without the condition. The hypothesis posits that this narrowing may cause congestion of blood in the brain and trigger attacks of inflammation, possibly by causing iron deposits.
“Liberation treatment” is the term coined by Dr. Zamboni of Italy for the dilation or repair of these narrowed veins. A catheter with a balloon is inserted into the narrowed vein and then the balloon is inflated to correct the narrowing. Some surgeons have placed stents (metal tubes) in the narrowing to prevent blockages from recurring.
- E-mail the CCSVI Research Team
- Vancouver Coastal Health Research Institute
- UBC MRI Research Centre
- MS Society