Canadian study suggests no link between venous stenosis and multiple sclerosis

Paolo Zamboni

There is no evidence that impaired blood flow or blockage in the veins of the neck or head is involved in multiple sclerosis, says a study from McMaster University.

The research, published online by PLOS ONE on 14 August 2013, found no evidence of abnormalities in the internal jugular or vertebral veins or in the deep cerebral veins of any of 100 patients with multiple sclerosis compared with 100 people who had no history of any neurological condition.

The study contradicts a controversial theory that says that multiple sclerosis is associated with abnormalities in the drainage of venous blood from the brain. In 2008 Italian researcher Paolo Zamboni, director Vascular Diseases Center, University of Ferrara, Ferrara, Italy, said that angioplasty would help multiple sclerosis patients with a condition he called chronic cerebrospinal venous insufficiency (CCSVI). This caused a flood of public response in Canada and elsewhere, with many concerned individuals lobbying for support of the “Liberation Treatment” to clear the veins, as advocated by Zamboni.

“This is the first Canadian study to provide compelling evidence against the involvement of CCSVI in multiple sclerosis,” said principal investigator Ian Rodger, a professor emeritus of medicine in the Michael G DeGroote School of Medicine, Hamilton, Canada. “Our findings bring a much needed perspective to the debate surrounding venous angioplasty for multiple sclerosis patients”.

In the study all participants received an ultrasound of deep cerebral veins and neck veins as well as an MRI of the neck veins and brain. Each participant had both examinations performed on the same day at St Joseph’s Healthcare, Hamilton, Canada. The McMaster research team included a radiologist and two ultrasound technicians who had trained in the Zamboni technique at the Department of Vascular Surgery of the University of Ferrara.

The research was funded by a collection of private donors, as well as many concerned individuals who contributed through St Joseph’s Healthcare Foundation.