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 (chronic cerebrospinal venous insufficiency) in MS, an abnormality of blood drainage from the brain and spinal cord in MS originally reported by Dr. Paolo Zamboni. The new projects take a comprehensive look at 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 unbiased results. Following is a description of one of the seven projects. Read the 18 month progress reports from all seven projects.
Title: “CCSVI and its relationship to MS”
Jerry S. Wolinsky, MD
University of Texas Health Science Center at Houston
Houston, Texas
Term/Amount: 7/1/10-6/30/12; $574,958
- 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. Wolinsky has assembled an expert team to increase understanding of CCSVI, testing several imaging methods.
- Validating a reliable diagnostic approach and demonstrating that CCSVI is specific to MS and contributes to disease activity would be necessary first steps before controlled therapeutic trials may be attempted.
About the Investigator: Dr. Wolinsky is the Bartels Family and Opal C. Rankin Professor of Neurology and a member of the graduate faculty of the Graduate School of Biomedical Sciences at The University of Texas Health Science Center at Houston. He directs the MS Research Group and the MRI Analysis Center. Dr. Wolinsky received his MD from The University of Illinois in 1969, and completed residency training in clinical neurology and a fellowship in experimental neuropathology at The University of California San Francisco. He subsequently joined the faculty of The Johns Hopkins University Schools of Medicine, and Hygiene and Public Health before settling in Houston. Dr. Wolinsky is active in the design, conduct and analysis of clinical trials in MS and conducts basic and applied imaging research. He is Chair of the National Clinical Advisory Board of the National MS Society. Dr. Wolinsky is recognized in The Best Doctors in America and America's Top Doctors, and has authored over 200 publications relating to neurovirology, neuroimmunology, and MS.
Dr. Wolinsky’s collaborators in this project are a stellar cast from the university, including include the overseer of the university’s cerebral vascular disease program, its chair of diagnostic and interventional imaging, director of MR research, director of the MS clinic, and chief of cardiovascular MRI.
Project Details: 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 study to definitively evaluate the possible impact of CCSVI on the disease process in MS.
Dr. Wolinsky has assembled an expert team to increase our understanding of CCSVI. Using a comprehensive approach, this team will first attempt to replicate the ultrasound methods used by Dr. Zamboni in 120 people with all major clinical types of MS, compared with 175 people in various non-MS control groups. Then, they are seeking to determine whether the findings are validated by noninvasive imaging techniques, such as an MRI machine using a powerful magnet. The team includes experts in MS, as well as experts from other fields such as vascular disease and venous imaging.
Validating a reliable diagnostic approach and demonstrating that CCSVI is specific to MS and contributes to disease activity would be necessary first steps before controlled therapeutic trials may be attempted.
Quotes – Dr. Jerry Wolinsky
- “Periodically, therapeutic claims for new approaches to MS receive widespread attention… If CCSVI exists and is associated with MS, it must be independently confirmed.”
- “This project will pursue four overlapped steps to develop understanding of this condition... Validating a reliable diagnostic approach and demonstrating an MS-specific association is prerequisite to any randomized, blinded therapeutic trial of venoplasty for MS.”