In a study of 16 people either with or without MS, the occurrence of CCSVI
(chronic cerebrospinal venous insufficiency) was reduced when participants were sufficiently hydrated. The findings offer one possible explanation for the varying results of reported CCSVI studies. Claudiu Diaconu, BS, Esther Soo H. Kim, MD, MPH, RPVI, and colleagues at Cleveland Clinic – who are conducting a National MS Society-supported CCSVI study led by Robert J. Fox, MD – conducted this separate study and report the results in Neurology Clinical Practice (2013; 3:386-391)
. These results were originally reported at the ECTRIMS meeting in 2012.
In June 2010, the National MS Society (USA) and the MS Society of Canada committed over $2.4 million to support seven new research projects on the role of CCSVI in MS, a postulated abnormality of blood drainage from the brain and spinal cord in MS originally reported by Paolo Zamboni, MD (University of Ferrara, Italy). In the interim since the Society-funded studies began, there have been conflicting results reported on the prevalence of CCSVI in MS, and the emergence of reports of CCSVI in people who do not have MS. There has also been variability in the methods used to study this phenomenon, including by Dr. Zamboni.
The Society-supported projects examine the structure and function of veins draining the brain and spinal cord in people representing a spectrum of MS types, severities and durations, and compare them to structure and function of veins in people with other diseases and healthy volunteers. The studies incorporate high standards of experimental blinding and controls designed to provide objective results.
This team conducted a study in which 11 people with MS and 5 non-MS controls fasted from food and drink for 12 hours before undergoing Doppler ultrasound evaluation for CCSVI. They then drank a 1.5-liter sports drink to replenish their fluids and then underwent ultrasound again.
Before hydration, 7 out of 16 met two or more criteria that define CCSVI. After hydration, only 2 out of 7 still met criteria for CCSVI. One person met CCSVI criteria only after hydration.
These results suggest that studies of CCSVI should standardize the state of hydration among participants, and also offers one possible explanation for the varied results of reported CCSVI studies. The authors comment that, although they cannot draw definite conclusions from this small sample size, dehydration may particularly be a factor in people with MS, who may prefer to drink less fluid because of bladder dysfunction.
This study adds to a growing body of evidence exploring the phenomenon of CCSVI and imaging technologies to study it. Additional results expected from this and other teams in coming months should shed further light on CCSVI and its implications for people who live with MS and for advocacy organizations such as the National MS Society, whose research focuses on speeding research toward stopping MS, restoring function, and ending MS forever.