Abstract Details

Title An Assessment of Chronic Cerebrospinal Venous Insufficiency in MS

Topic MS and Related Diseases

Presentation(s) P05 - (-)

Poster/Presentation
Number 177

Objective

Background BACKGROUND: CCSVI is a hypothesis of MS pathogenesis related to venous outflow from the head, with conflicting results from different studies. Recent studies have found a very low prevalence of CCSVI, suggesting that those investigators were performing ultrasound assessments differently than the original reports.

Design/Methods DESIGN/METHODS: After obtaining formal training in CCSVI ultrasound techniques, we performed ultrasound assessments on a group of 61 MS subjects (4 CIS, 28 RRMS, 19 SPMS, 10 PPMS; 42 females) and 20 non-MS controls (15 healthy and 5 other neurological diseases; 10 female). Ultrasonographers were blinded to diagnosis, and separate research staff positioned subjects prior to ultrasonographer arrival. Assessments were performed using a Biosound MyLab25, equipped with Quality Doppler Profiles (QDP) technology, and traditional transcranial Doppler. Two published interpretations of CCSVI Criteria were utilized: Narrow Criteria did not include either B-mode intraluminal abnormalities or QDP technology for deep cerebral vein reflux, while Broad Criteria included both of these.

Results RESULTS: Using either Narrow Criteria or Broad Criteria, there were no significant differences between MS subjects and controls (p>0.5 for both comparisons). In both groups, there was a doubling of the proportion of subjects meeting CCSVI criteria when using the Broad Criteria.

Conclusions CONCLUSIONS: Using trained and blinded ultrasonographers and QDP technology, we observed no difference in the proportion of MS subjects meeting CCSVI criteria compared to non-MS controls. Different interpretations of CCSVI criteria altered the proportions of subjects meeting CCSVI criteria, highlighting the importance of criteria interpretations when comparing the prevalence of CCSVI between studies. These observations do not support a significantly increased prevalence of CCSVI in MS and suggest against a pathogenic role of CCSVI in MS.

Authors/Disclosures
Robert J. Fox, MD, FAAN (Cleveland Clinic) PRESENTER	Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AB Science. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for EMD Serono. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Immunic. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Fox has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for TG Therapeutics. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Siemens. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Roche. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astoria Biologica. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving as a Consultant for InnoCare Pharma. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Immunic. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AB Science. Dr. Fox has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Fox has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS. The institution of Dr. Fox has received research support from National Institutes of Health. The institution of Dr. Fox has received research support from National MS Society. Dr. Fox has received publishing royalties from a publication relating to health care.
	No disclosure on file
Claudiu I. Diaconu, MD (White Plains Hospital Physician Associates)	No disclosure on file
	No disclosure on file
	No disclosure on file
Regina Berkovich, MD, PhD (Regina Berkovich MD PhD Inc)	The institution of Dr. Berkovich has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Alexion, Biogen, Genentec, Mallincrodt, Sanofi, Novartis, . Dr. Berkovich has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen, Genentec, Sanofi, Merck . Dr. Berkovich has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Alexion, Biogen, Sanofi, Merck, Mallincrodt . The institution of Dr. Berkovich has received research support from Biogen, Sanofi, Merck.
	No disclosure on file
	No disclosure on file
Mei Lu, MD (cleveland clinic)	No disclosure on file
	No disclosure on file
	No disclosure on file
Alex D. Rae-Grant, MD, FRCPC, FAAN (Ebsco Information Services)	Dr. Rae-Grant has received publishing royalties from a publication relating to health care. Dr. Rae-Grant has received publishing royalties from a publication relating to health care.

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