CCSVI does not predict MS risk or severity

Background: It is unclear whether chronic cerebrospinal venous insufficiency (CCSVI) is associated with MS, because substantial methodological differences have been claimed by Zamboni to account for the lack of results of other groups. Furthermore, the potential role of venous malformations in influencing MS severity has not been fully explored. This information is particularly relevant, because uncontrolled surgical procedures are increasingly offered to MS patients to treat their venous stenoses.

Methods: In the present study, CCSVI was studied in 84 MS’ers and in 56 healthy subjects by applying the Zamboni method for CCSVI identification.
Results: The investigators found no differences in CCSVI frequency between MS’ers and control subjects. Furthermore, no differences were found between CCSVI-positive and CCSVI-negative MS’ers in terms of relevant clinical variables such as disease duration, time between onset and first relapse, relapsing or progressive disease course, and risk of secondary progression course. 
ConclusionsCCSVI has no role in either MS risk or MS severity.

Centonze et al. Proposed chronic cerebrospinal venous insufficiency criteria do not predict multiple sclerosis risk or severity. Ann Neurol. 2011 Jul;70(1):52-9. doi: 10.1002/ana.22436.

“CCSVI falls down on the first criterion proposed by Sir Austin Bradford-Hill (see post below).”
CoI: Nil
Other posts on CCSVI on this blog:
30 Jun 2011
CCSVI is simply a placebo effect. MS’ers are so desperate they’re willing to try anything resembling effective treatment. I sometimes think that MS’ers are holding back progress by jumping on unproven bandwagons. 
25 Jun 2011
The purpose of this study was to evaluate the safety of endovascular treatment of chronic cerebrovascular insufficiency (CCSVI) in patients with MS. In a 1-year period 461 MS’ers underwent endovascular treatment of 1012 
25 Jun 2011
Why is this important for CCSVI? The venous system is a capacitance system; i.e. it stores blood. When MS’ers dehydrate themselves they will almost certainly reduce the amount of blood in the venous system, 
24 Jun 2011
This study was performed to determine how common CCSVI is in a large group of patients with MS, clinically isolated syndrome, other neurologic diseases, and healthy controls, using specific diagnostic criteria using an 

20 May 2011
The following are the results of our survey on CCSVI that has just closed. Surprisingly only 10% of respondents thought that CCSVI is the cause of MS. Almost a quarter of people think it is an established disease. 
21 Jun 2011
Klaus’ annual CCSVI stand-up routine is fast becoming an institution. Maybe next year he’ll even do some proper research rather than just Googling for some ‘hilarious’ images… Thursday, June 23, 2011 2:28:00 PM 
04 May 2011
CCSVI – The rise of people power. Italy and Canada bare the brunt of the CCSVI lobby (please see link and picture below). Is this the way to prioritize research? Chafe et al. Nature 472, 410–411 (28 April 2011). 
15 Apr 2011
CCSVI – time for Sir Bradford-Hill’s criteria for causation. Did you know that there is a whole science behind causation? It started way back in the later 1800’s when Robert Koch formulated his postulates to persuade his 

14 Apr 2011
Those with results suggestive of CCSVI underwent selective venography (the gold standard for diagnosing diseases of blood vessels). Fifty healthy age- and gender-matched controls were studied. 
22 Apr 2011
If any one is interested in CCSVI they should read “Bad Science” by Ben Goldacre; the book provides the social context to the CCSVI phenomenon. Please see
14 Apr 2011
CCSVI: value of MR venography for detection of internal jugular vein anomalies in MS: a pilot longitudinal study. Zivadinov R, et al. AJNR Am J Neuroradiol. 2011 Apr 7. [Epub ahead of print] 
11 Nov 2009
The “big idea” underlying the presumed link between CCSVI and MS is that narrowing in large veins outside the central nervous system (CNS) leads to stagnation of venous blood in small veins within the CNS and, 
Etc. Search term “CCSVI”

3 thoughts on “CCSVI does not predict MS risk or severity”

  1. ‘The investigators found no differences in CCSVI frequency between MS'ers and control subjects.’If this is the case, it’s pretty clear that the researchers didn’t know what they were doing. The work going on around the world on this (Buffalo etc etc) is showing that, at the very least, the presence of CCSVI is considerably more common in MS’ers than controls. Well I suppose it’s progress from the earlier papers in the ‘Anals of Neurology’ where CCSVI was conclusively found not to even exist…As you tweeted the other day:‘All truth passes through 3 stages: it is ridiculed, it is violently opposed and finally it is accepted as self-evident.’ SchopenhauerAs far as Sir AB-H goes, it’s almost impossible to find any area of ‘CONSISTENCY AND UNBIASEDNESS OF FINDINGS’ in the field of MS research. Indeed, you often illustrate that on this very splendid blog.

  2. I found this via the MSRC site:“Symptom Improvement Observed After Venoplasty in MS Patients” the moment I think symptom relief from the daily onslaught of MS is the area that should be foremost in the mind of Neurologists regarding CCSVI treatment. It will be a while yet before any conclusions can be reached in the relationship between CCSVI and MS. I, and many others, have had the sort of symptom relief that this initial study has also found. This includes improvements in fatigue, lower-extremity weakness and walking speed. QOL, QOL, QOL…

  3. RE: 'Indeed, you often illustrate that on this very splendid blog.' To clarify, I mean in the stories you post up, NOT your position… I'll stop talking to myself now.

Leave a Reply

%d bloggers like this: