MS and CCSVI: The Science

Carl Jung’s  “synchronicity” has come to my rescue again.  Just when I needed an answer to my “heart” problem, Italian researchers confirmed my own analysis of my heart “event”. Early January 2015  I rose abruptly, even violently, from lying quietly in bed. Briefly, I had difficulty breathing. Three strangled breaths followed before my respiration returned  to normal.  I surmised that what I believe to be compromised blood vessels had briefly collapsed. Once the blood flow resumed, the crisis ended.  However, I couldn’t exclude a heart problem so mid February I made an appointment with a Cardiologist.  Mid March the Cardiologist performed an EKG and another test to conclude that the heart was normal, but there was a problem with the aorta and she recommended a “Scintigraphic myocardique”.

I’ve put off getting the exam until the autumn (if not indefinitely). The Cardiologist ignored me when I suggested that the problem was one of blood flow through the brain as suggested by the CCSVI theory of MS.  I don’t want someone to begin working on one aspect of my blood circulatory system while ignoring the CCSVI issue.  (Of course it has been only six plus years since Professor Zamboni published his CCSVI paper on the Internet so general medical ignorance of a theory which has met ferocious opposition might be expected. That doesn’t mean one should ignore the concerns of an informed patient.)  

Back to “Synchronicity”. Just when I requested a referral to a Cardiologist, PLOS ONE published  the following paper on Feb 13, 2015.

Cerebral Circulation Time is Prolonged and Not Correlated with EDSS in Multiple Sclerosis Patients: A Study Using Digital Subtracted Angiography 
http://www.plosone.org/article/fetchObject.action?uri=info%3Adoi%2F10.1371%2Fjournal.pone.0116681&representation=PDF

I recently read the article on Joan Beal’s excellent Blog titled “Multiple Sclerosis – The Vascular Connection” http://ccsviinms..com/2015/05/b ... tters.html.  (She participates regularly as "cheerleader" on the site Thisisms.com.) Her blog is the indispensable resource for current scientific research on the brain and central nervous system which ventures away from the auto-immune ideology of MS.  (Her interest in MS? Her explanation I quote here.)

“I became interested in multiple sclerosis (MS) research when my husband Jeff was diagnosed with MS in 2007. I noted a connection of Jeff's disease process to his circulation and blood, and by accessing medical journals on the internet and stacks of books at my local library, I put together research to address this. I sent my theory and research, called the Endothelial Health Program, to universities, and began a correspondence with vascular specialists at Stanford University. Jeff was the first American treated for CCSVI, and he is now six years past his venoplasty, with no further MS progression, healing of his gray matter, and relief of many symptoms.”

Excerpts from her February 23, 2015 blog post follow:   

« Cerebral Circulation---2x slower in people with MS A brand new blinded study has found that it takes almost twice as long for blood to flow from the heart, through the brain, and back to the heart in people with MS, when compared to normals.

Cerebral circulation time (CCT) in people with MS was not tied to disability, or length of time with an MS diagnosis.  Slowed CCT was found in all people with MS, when compared to age matched controls.

Forty four control subjects showed a median time of 2.8 seconds for cerebral circulation.  The 80 patients with MS had a median time of 4.8 seconds…

Cerebral hypoperfusion, or slowed blood flow, has been noted in multiple sclerosis for decades.  Many have theorized that this slowed blood flow is a result of damage to the MS brain.  That inflammation, lesions, edema and loss of neurons would lead to less perfusion.  But this has only been a theory.

What is revolutionary about this new, blinded study--is the evidence that cerebral hypoperfusion occurs in the earliest stages of MS, and precedes white matter lesions and neurodegeneration.  This slowed blood flow appears to be the very first step in the MS disease process.  Hypoperfusion is not a result of MS, it may be the cause… that this is a specific marker for MS…

This is the second peer-reviewed, published and blinded study to show cerebral circulation time is markedly slower in pwMS when compared to normals.  The first study was published in 2012, and utilized doppler ultrasound, rather than angiography.   
http://www.ncbi.nlm.nih.gov/pubmed/22357894...
The brain needs a constant supply of oxygen and glucose, and when blood flow is disrupted, damage occurs. Researchers have seen hypoperfusion and ischemic injury in MS for many years.

Dr. Zamboni and Dr. Zivadinov published a study in 2010 showing how severity of CCSVI was linked to severity of hypoperfusion:

To the best of our knowledge, this pilot study is the first to report a significant relationship between the presence and severity of CCSVI and hypoperfusion in the brain parenchyma… 

Neurological researchers can no longer claim that cerebral blood flow is not important.  New technologies are allowing us to see how hypoperfusion and slowed cerebral circulation time is impacting the brain….

There is a very real and measurable vascular connection to MS and diseases of neurodegeneration.
And new research is showing us how important the heart-brain connection is.” End of Quote

Back to the present. So what does this mean for me, the “Heart-Brain connection”? I believe that on a morning in January 2015 I rose so abruptly that the blood in my head was delayed in descending to the heart which left me gasping for breathe. Maybe this interruption in blood flow actually did injure the aorta.  In future I will take great care to rise slowly and not repeat the experience.  And I will continue my efforts to strengthen the endothelium of the veins AND arteries through nutrition, supplements, exercise, UV rays and fluid circulation therapies such as Osteopathy and Acupuncture. As it turns out advice for a healthy cardio-vascular system is the same as for a healthy brain and treating MS.

In March 2011 the International Society for NeuroVascular Disease (ISNVD) was founded at a meeting in Bologna Italy. The Fifth annual ISNVD conference was held in Naples the month of March 2015. In her March blog post Joan Beal provides brief synopses of the research abstracts.  Her titles follow here.

http://isnvd.org/d/sites/default/files/Invited%20Speaker%20abstracts%20-%20all.pdf


“2D and 3D analysis of vessels in the retina and the brain

Venous dysfunction and neurodegenerative diseases

Blood storage within the intracranial space and its impact on cerebrospinal fluid dynamics

Advances in Treatment Strategies of Extracranial Venous Disease

Imaging of Brain Microvascular Disorders: lessons from the CADASIL model.

.Endothelin- 1 as a potential target for chronic brain hypoperfusion

TBI and hemodynamic changes in the brain

Ultrasound contrast imaging of brain hemodynamic and perfusion Marcello Mancini, M.D.

Imaging of the Microvasculature

Update in computational fluid modelling of the brain

Clinical Applications of Venous Treatment

The Heart Brain Connection

A novel sonographic method for reproducible jugular vein pulse wave assessment

 Is there a role for mast cells dependent synthesis of Endothelin-1 in neurodegenerative diseases?

Venous abnormalities in Meniere's Disease

 Advances in Idiopathic Intracranial Hypertension Pathogensis: a Focus on Sinus Venous Stenosis

In Endothelial function, the glymphatic system and New Drug Development

 Endothelial dysfunction in neurodegenerative disease

Fluid Dynamic Influences on Cerebrovascular Endothelial Activation Responses

Cardiovascular risk factors and neurodegenerative disorders” End of quote

While not the first to suggest the vascular connection to MS, Professor Zamboni was perhaps the first allopathic Doctor to suggest a treatment – using Angioplasty (Venoplasty) to free blood circulation by ballooning the stenosed veins. Unfortunately there is a tendency for the Allopaths to want to monopolize treatment which leaves the MSer somewhat emptyhanded if she doesn’t want (or can’t) undergo Venoplasty.  One can do a lot more than eat better, stop smoking and exercise.

If we want to get the central nervous system fluids circulating (blood, cerebrospinal, and now glymphatic) we can get treated by an Osteopath, Acupuncturist, Ayurvedic Massage therapist, (Massage in general), and/or Chiropractor. We can treat ourselves with TENS Acupressure. That is where MS Cure Enigmas comes in, figuring out what we need to do to heal.  I’m still reflecting on how I can revise my site.  I may reduce MS categories to TWO basic types: 1) Venous abnormalities and 2) Skeletal obstructions. Skeletal obstructions require an entirely different treatment protocol than stenosed or defective veins (and I actually believe these define Progressive MS).

Major factors leading to my MS.  1) food sensitivities led to childhood malnutrition 2) Mononucleosis age 9 (EBV virus) damaged the endothelium (vein walls)  3)  lack of UV rays (Vit D and Nitric Oxide release) 4) both parents smoked 5) stressful family environment 6) birth control pills 2 years (minor influence). All of these factors could have damaged the endothelium and retarded proper development of the vascular system.  On the plus side, lot’s of exercise.



Tags: Multiple Sclerosis, MS, CCSVI, cerebral hypoperfusion, heart-brain connection, endothelium, cardiovascular system, ISNVD