Robert J. Fox, M.D.
Cleveland Clinic Foundation
Term/Amount: 7/1/10-9/30/13 (extension granted); $571,261
About the Investigator:
A series of recent publications have suggested that some people with MS have obstructions in the veins that drain blood in the brain and spinal cord that may contribute to nervous system damage in MS.
Dr. Fox and a multi-disciplinary team are seeking to reproduce these findings in 90 people with MS and 80 control subjects without MS, using various tests, as well as examining vein tissues obtained via autopsy.
Data from these studies will provide a comprehensive foundation upon which to either design further longitudinal and intervention studies, or reject this hypothesis of MS pathogenesis.
Dr. Robert J. Fox is an award-winning clinical researcher who is dedicated to finding better therapies for people with MS. He is currently Medical Director of the Mellen Center for Multiple Sclerosis Treatment and Research at Cleveland Clinic, where he conducts clinical trials in MS and serves as a peer reviewer and advisor to many agencies including the National MS Society’s headquarters and local Ohio Buckeye Chapter.
He graduated with a BA in neuroscience Summa cum laude from Amherst College and received his MD from Johns Hopkins University. He did his residency in neurology at the Hospital of the University of Pennsylvania. His National MS Society-supported Sylvia Lawry Physician Fellowship at Cleveland Clinic enabled him to gain hands-on experience conducting MS clinical trials and to pursue a Master’s in clinical research from Case Western Reserve University.
Dr. Fox’s multi-disciplinary team includes the medical director of the Cleveland Clinic’s neurovascular laboratory, an expert cardiologist in venous ultrasound, the section head of imaging sciences, and others with expertise in neuropathology, anatomy, biomedical engineering, and biostatistics. By assimilating such a diverse team of experts in their respective fields, a complete and accurate assessment of CCSVI will be performed.
Recent preliminary studies have suggested that a phenomenon called Chronic Cerebrospinal Venous Insufficiency (CCSVI), a reported abnormality in blood drainage from the brain and spinal cord, may contribute to nervous system damage in MS. This hypothesis has been put forth by Dr. Paolo Zamboni from the University of Ferrara in Italy. This pilot study warrants a subsequent larger and better controlled studies to definitively evaluate the possible impact of CCSVI on the disease process in MS.
Dr. Fox and his team are seeking to reproduce these findings in 90 people with different forms of MS and 80 controls without MS. His team is conducting the same tests that were done in the original studies (ultrasound tests of the veins in the neck), an MRI test that looks specifically at veins, and neurological examinations. Most of these MS patients have been followed for the past 10 years in a longitudinal study using quantitative clinical and imaging measures, which will provide an opportunity to compare CCSVI findings to MS disease evolution. To distinguish whether vein abnormalities are from atrophy (brain tissue volume loss) and not specifically MS, they also are comparing the MS group to people with atrophy from Alzheimer's disease. Finally, they are examining the neck and spinal cord veins obtained via autopsy from people with MS and non-MS controls.
Data from these studies will shed light on the meaning of Dr. Zamboni’s original reports and how CCSVI relates to disease activity in MS.