The procedure Zamboni described involves surgically threading a balloon catheter through the body and into two major veins, the azygous and the jugular vein. The balloon is inflated to expand the veins’ walls. Zamboni’s unproven hypothesis is that the brain legions that cause MS symptoms arise from blocked and twisted veins.

This procedure, which he developed in Italy at the University of Ferrera, showed that the improper drainage of blood from the brain may play a part in causing MS. That means treatment of the disease could be by simply opening up the blood vessels to the brain – a procedure called “liberation therapy.”

Quebec Health Minister Yves Bolduc says the province would be willing to join a national clinical trial of the so-called liberation procedure.

The treatment is based on an unproven theory that blocked veins in the neck or spinal cord are to blame for M-S, a chronic disease of the nervous system.

“I appreciate what people are going through — living with MS can be a terrible thing and they are anxious to pursue any treatment possibilities, but that has to be balanced against ensuring that the treatment actually works,” Dr. Jon Stoessl says.

Peter Sundström, M.D., of Umea University in Sweden, and colleagues assessed blood flow in the internal carotid arteries, vertebral arteries, and internal jugular veins (IJV) in 21 patients with MS and 20 healthy controls to test the vascular MS hypothesis. They found no significant differences between patients and controls in either total IJV blood flow or the amount of cerebral blood flow returning.

Recent research has strongly associated chronic cerebrospinal venous insufficiency (CCSVI) with MS.

October 15, 2009, 6:36 AM

Buffalo physicians announced Wednesday that they have started a large study that could overturn thinking about the generally accepted cause for multiple sclerosis.

MS is believed to stem from an abnormal response of the body’s immune system directed against the fatty sheath that surrounds nerve fibers in the brain and spinal cord.

But no one knows for sure, and recent research suggests an altogether different explanation for the disabling disease — narrowing of the primary veins outside the skull, a condition called chronic cerebrospinal venous insufficiency, or CCSVI.

The narrowing restricts the normal outflow of blood from the brain, causing alterations in the blood flow patterns within the brain that eventually cause injury to brain tissue and degeneration of neurons, the researchers said.

“If we can prove our hypothesis — that cerebrospinal venous insufficiency is the underlying cause of MS — it is going to change the face of how we understand MS,” said Dr. Robert Zivadinov, director of the Buffalo Neuroimaging Analysis Center at Kaleida Health’s Buffalo General Hospital.

Zivadinov, principal investigator in the study, is also a University at Buffalo associate professor of neurology.

Such a finding may allow doctors to identify individuals born with the abnormalities before they develop MS symptoms, treat the problem and perhaps even prevent it.

About 400,000 Americans suffer from MS, and because no cure exists, there is intense interest in new insights and potential treatments. Zivadinov urged caution, saying the work remains very preliminary.

A 2009 study by an Italian researcher, Dr. Paolo Zamboni, of 65 people with MS and 235 people with no or other neurological disorders found a strong relationship between MS and signs of abnormal blood drainage in veins. Zivadinov took part in small follow-up studies.

The researchers here now plan a larger, more rigorously designed trial that will involve 1,600 adults and 100 children and include a look at other factors involved in the disease.

It could be that CCSVI interacts with environmental, genetic or infectious triggers to initiate an abnormal immune response and the degeneration of nerve tissue, Zivadinov said.

The National Multiple Sclerosis Society, in a recent statement, offered a cautious response to the new study, saying that many questions remain about how and when the obstruction of veins might play a role in damage to the nervous system seen in MS.

“At the present time,” the organization said, “there is insufficient evidence to suggest that this phenomenon is the cause of MS.”