Chronic cerebrospinal venous insufficiency is not associated with multiple sclerosis and its severity: a blind-verified study.

<h4>Background</h4>Chronic Cerebrospinal Venous Insufficiency (CCSVI) has been associated with multiple sclerosis (MS) with a risk ranging from as high as two-hundred-fold to a protective effect. However, not all studies were blinded, and the efficacy of blinding was never assessed.<h...

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Autores principales:	Maurizio A Leone, Olga Raymkulova, Paola Naldi, Piergiorgio Lochner, Laura Bolamperti, Lorenzo Coppo, Alessandro Stecco, William Liboni
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b6166285699b4ea296b6c94aad23783c
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spelling	oai:doaj.org-article:b6166285699b4ea296b6c94aad23783c2021-11-18T07:57:44ZChronic cerebrospinal venous insufficiency is not associated with multiple sclerosis and its severity: a blind-verified study.1932-620310.1371/journal.pone.0056031https://doaj.org/article/b6166285699b4ea296b6c94aad23783c2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23418501/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Chronic Cerebrospinal Venous Insufficiency (CCSVI) has been associated with multiple sclerosis (MS) with a risk ranging from as high as two-hundred-fold to a protective effect. However, not all studies were blinded, and the efficacy of blinding was never assessed.<h4>Objective</h4>To evaluate the association of CCSVI with MS in a cross-sectional blinded study and look for any association of CCSVI with the severity of MS.<h4>Methodology/principal findings</h4>The Echo-color Doppler examination was carried out in accordance with Zamboni's five criteria in 68 consecutive MS patients and 68 healthy controls, matched by gender and age (±5 years). Four experienced neurosonologists, blinded to the status of cases and controls, performed the study and were then asked to guess the status (case or control) of each participant. The number of positive CCSVI criteria was similar in the two groups. CCSVI, defined as the presence of two or more criteria, was detected in 21 cases (30.9%) and 23 controls (33.8%), with an OR of 0.9 (95%CL = 0.4-1.8, p = 0.71). The prevalence of CCSVI was related to age in cases (OR increasing from 0.2 to 1.4), but not in controls. CCSVI positive (N = 21) and negative (N = 47) MS patients were similar in clinical type, age at disease onset, disability, and fatigue. Disease duration was longer (16.5±9.8 years) in CCSVI positive than negative patients (11.5±7.4; p = 0.04). The operators correctly guessed 34/68 cases (50%) and 45/68 controls (66%) (p = 0.06), indicating a different success of blinding.<h4>Conclusions/significance</h4>CCSVI was not associated with MS itself, nor its severity. We cannot rule out the possibility that CCSVI is a consequence of MS or of aging. Blinding of sonographers is a key point in studying CCSVI and its verification should be a requisite of future studies.Maurizio A LeoneOlga RaymkulovaPaola NaldiPiergiorgio LochnerLaura BolampertiLorenzo CoppoAlessandro SteccoWilliam LiboniPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 2, p e56031 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Maurizio A Leone Olga Raymkulova Paola Naldi Piergiorgio Lochner Laura Bolamperti Lorenzo Coppo Alessandro Stecco William Liboni Chronic cerebrospinal venous insufficiency is not associated with multiple sclerosis and its severity: a blind-verified study.
description	<h4>Background</h4>Chronic Cerebrospinal Venous Insufficiency (CCSVI) has been associated with multiple sclerosis (MS) with a risk ranging from as high as two-hundred-fold to a protective effect. However, not all studies were blinded, and the efficacy of blinding was never assessed.<h4>Objective</h4>To evaluate the association of CCSVI with MS in a cross-sectional blinded study and look for any association of CCSVI with the severity of MS.<h4>Methodology/principal findings</h4>The Echo-color Doppler examination was carried out in accordance with Zamboni's five criteria in 68 consecutive MS patients and 68 healthy controls, matched by gender and age (±5 years). Four experienced neurosonologists, blinded to the status of cases and controls, performed the study and were then asked to guess the status (case or control) of each participant. The number of positive CCSVI criteria was similar in the two groups. CCSVI, defined as the presence of two or more criteria, was detected in 21 cases (30.9%) and 23 controls (33.8%), with an OR of 0.9 (95%CL = 0.4-1.8, p = 0.71). The prevalence of CCSVI was related to age in cases (OR increasing from 0.2 to 1.4), but not in controls. CCSVI positive (N = 21) and negative (N = 47) MS patients were similar in clinical type, age at disease onset, disability, and fatigue. Disease duration was longer (16.5±9.8 years) in CCSVI positive than negative patients (11.5±7.4; p = 0.04). The operators correctly guessed 34/68 cases (50%) and 45/68 controls (66%) (p = 0.06), indicating a different success of blinding.<h4>Conclusions/significance</h4>CCSVI was not associated with MS itself, nor its severity. We cannot rule out the possibility that CCSVI is a consequence of MS or of aging. Blinding of sonographers is a key point in studying CCSVI and its verification should be a requisite of future studies.
format	article
author	Maurizio A Leone Olga Raymkulova Paola Naldi Piergiorgio Lochner Laura Bolamperti Lorenzo Coppo Alessandro Stecco William Liboni
author_facet	Maurizio A Leone Olga Raymkulova Paola Naldi Piergiorgio Lochner Laura Bolamperti Lorenzo Coppo Alessandro Stecco William Liboni
author_sort	Maurizio A Leone
title	Chronic cerebrospinal venous insufficiency is not associated with multiple sclerosis and its severity: a blind-verified study.
title_short	Chronic cerebrospinal venous insufficiency is not associated with multiple sclerosis and its severity: a blind-verified study.
title_full	Chronic cerebrospinal venous insufficiency is not associated with multiple sclerosis and its severity: a blind-verified study.
title_fullStr	Chronic cerebrospinal venous insufficiency is not associated with multiple sclerosis and its severity: a blind-verified study.
title_full_unstemmed	Chronic cerebrospinal venous insufficiency is not associated with multiple sclerosis and its severity: a blind-verified study.
title_sort	chronic cerebrospinal venous insufficiency is not associated with multiple sclerosis and its severity: a blind-verified study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/b6166285699b4ea296b6c94aad23783c
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Chronic cerebrospinal venous insufficiency is not associated with multiple sclerosis and its severity: a blind-verified study.

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