What causes multiple sclerosis? There are plenty of theories, but researchers have yet to hone in on the answer.
Researchers at the Buffalo Neuroimaging Analysis Center at the University of Buffalo will be looking into the possibility that MS results from narrowing of the primary veins outside the skull — chronic cerebrospinal venous insufficiency. In CCSVI, narrowing of the veins restricts the flow of blood from the brain, causing degeneration of neurons.
CCSVI was discovered by Paolo Zamboni, M.D., from Italy’s University of Ferrara. Results of a preliminary study of 16 patients with relapsing/remitting MS and eight healthy controls showed that all the MS patients, but none of the controls, had chronic insufficient blood flow out of the brain.
Combined Transcranial and Extracranial Venous Doppler evaluation in multiple sclerosis and related diseases (CTEVD study) will evaluate blood flow in MS patients compared to health controls and controls with other neurological conditions.
The new study will be based on 1,100 people diagnosed with possible or definite MS and 300 healthy controls, plus 300 patients with other autoimmune and neurodegenerative diseases. Enrollment in the study has begun and will continue for two years. MS patients from across the U.S. are eligible to participate.
Participants will undergo clinical examination, Doppler scan of the head and neck, provide blood samples, and will be required to answer an extensive environmental questionnaire.
The National Multiple Sclerosis Society lists the main scientific theories about the cause of MS as:
- Immunologic: An abnormal response of the body’s immune system, causing it to attack myelin in the central nervous system.
- Environmental: MS occurs in greater numbers the farther you get from the equator. Researchers have been studying migration patterns in an effort to learn if exposure to an environmental agent at an early age may increase risk. Data suggests that people who move before puberty tend to acquire the risk of their new area. Research into the role of vitamin D and clusters of MS cases are ongoing.
- Infectious: More than a dozen viruses and bacteria are being investigated to determine if they are involved in the development of MS.
- Genetic: MS is not classified as hereditary, although having a first-degree relative with MS increases the risk. Some researchers theorize that certain people may have a genetic predisposition to react to an environmental cause.
If the CTEVD study does, in fact, point to CCSVI as a cause of MS, it would be possible to identify people at risk of developing MS before symptoms are obvious and permanent damage has begun.
“If we can prove our hypothesis, that cerebrospinal venous insufficiency is the underlying cause of MS,” said Robert Zivadinov, M.D., Ph.D., UB associate professor of neurology, director of the Buffalo Neuroimaging Analysis Center (BNAC) and principal investigator on the study, “it is going to change the face of how we understand MS.” (quote from MedicalNews.net, emphasis mine)
Isolating the cause of MS is the first step toward more effective treatments and, eventually, a cure for this debilitating condition. The good news is that research is ongoing on multiple fronts and the last decade has seen major progress in treatment of relapsing/remitting MS, as well as treatment of symptoms.
Change the face of how we understand MS? If that means finding the cause, it is good news indeed.
Writer Ann Pietrangelo embraces the concept of personal responsibility for health and wellness. As a multiple sclerosis patient, she combines a healthy lifestyle and education with modern medicine, and seeks to provide information and support to others. She is a regular contributor to Care2.com’s Reform Health Policy blog in Causes.