CSF dynamics and brain volume in multiple sclerosis are associated with extracranial venous flow anomalies: a pilot study

Int Angiol. 2010 Apr;29(2):140-8.


Aim: We previously reported unexpectedly robust associations between vascular haemodynamic (VH) anomalies in the principal extracranial cerebral veins, causing chronic cerebrospinal venous insufficiency (CCSVI), and multiple sclerosis (MS). Aim of this study was to investigate the relationship between the VH changes and MRI measures of MS disease severity in a cross sectional survey.

Methods: The number of anomalous VH criteria were measured using an echo-color Doppler, whereas CSF flow, atrophy and lesion measures were obtained from quantitative magnetic resonance imaging (MRI) analysis in sixteen consecutive relapsing-remitting MS patients, (mean age: 36.1+/-SD 7.3 years, disease duration: 7.5+/-1.9 years and median EDSS: 2.5) and in 8 healthy controls (HC) with similar age and sex distributions.

Results: All 16 MS patients investigated and none of the HCs met the VH criteria for CCSVI (P<0.0001). MS patients showed significantly lower net CSF flow compared to the HC (P=0.038) that was associated with number of anomalous VH criteria present (r=0.79, P<0.001). Moreover, increases in the number of anomalous VH criteria present were negatively associated with lower whole brain volume (Spearman R=-0.5, P=0.05).

Conclusion: VH changes occur more frequently in MS patients than controls. Altered VH is associated with abnormal CSF flow dynamics and decreased brain volume.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Atrophy
  • Azygos Vein* / abnormalities
  • Azygos Vein* / diagnostic imaging
  • Azygos Vein* / physiopathology
  • Brain / pathology*
  • Cerebral Veins / abnormalities
  • Cerebral Veins / diagnostic imaging
  • Cerebral Veins / physiopathology
  • Cerebrovascular Circulation
  • Constriction, Pathologic
  • Cross-Sectional Studies
  • Humans
  • Jugular Veins* / abnormalities
  • Jugular Veins* / diagnostic imaging
  • Jugular Veins* / physiopathology
  • Magnetic Resonance Imaging*
  • Multiple Sclerosis, Relapsing-Remitting / cerebrospinal fluid
  • Multiple Sclerosis, Relapsing-Remitting / diagnosis*
  • Multiple Sclerosis, Relapsing-Remitting / physiopathology
  • Organ Size
  • Pilot Projects
  • Regional Blood Flow
  • Spinal Cord / blood supply*
  • Ultrasonography, Doppler, Color*
  • Venous Insufficiency / cerebrospinal fluid
  • Venous Insufficiency / diagnosis*
  • Venous Insufficiency / physiopathology