BUFFALO, N.Y. -- Robert Zivadinov, MD, PhD, FAAN, University at
Buffalo professor of neurology, provided invited testimony today to
the Canadian Senate on Bill S-204, "An Act to establish a national
strategy for chronic cerebrospinal venous insufficiency
(CCSVI)."
CCSVI refers to impaired blood flow from the central nervous
system to the periphery. It has been hypothesized that this
narrowing of veins restricts blood flow from the brain, altering
brain drainage, and may contribute to brain tissue injury that is
associated with multiple sclerosis.
CCSVI has generated intense interest among MS patients
worldwide. Independent scientific studies, including one of the
largest to date being conducted by Zivadinov and UB colleagues,
have suggested an association with MS, although none have found
conclusively that the condition is associated with MS.
"While our research points against CCSVI having a primary
causative role in the development of MS, we have established that
there is a higher prevalence of CCSVI in progressive MS patients,"
said Zivadinov. "This suggests that CCSVI may contribute to, or be
a consequence of disease progression, with important implications
for treating its symptoms."
Zivadinov and his colleagues at the Buffalo Neuroimaging
Analysis Center, part of UB's Department of Neurology in the School
of Medicine and Biomedical Sciences, and at other institutions have
published or presented more than 25 studies on CCSVI.
One of these found that patients with other neurologic diseases
and healthy individuals also present with CCSVI, a finding that
Zivadinov noted further underscores the need for additional
research.
"CCSVI intervention should be restricted to blinded, randomized
and controlled clinical trials that will establish the safety and
efficacy of these endovascular procedures," Zivadinov said. "This
should be done according to established clinical, MRI (magnetic
resonance imaging), and quality of life treatment outcomes
employing safe and ethical approaches.
"Until these steps are accomplished, I believe there is no role
for endovascular treatment of CCSVI in MS patients or in patients
with other neurological disorders outside of approved clinical
trials," he concluded.