Study May Uncover New Cause of Multiple Sclerosis

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The cause of multiple sclerosis, a chronic, often debilitating disease that attacks the central nervous system, has puzzled doctors for decades. Now neurologists at the University at Buffalo, The State University of New York are embarking on research that may introduce an entirely new hypothesis as to what causes the disease.

Multiple sclerosis affects approximately 400,000 people in the United States, according to the National Multiple Sclerosis Society, and about 2.5 million around the world. It is generally accepted that multiple sclerosis is an autoimmune disease, which means the body’s immune system attacks certain parts of the body; in this case it is the myelin, the fatty sheath that surrounds and insulate nerve fibers in the central nervous system. Symptoms may be mild to severe and include fatigue, numbness of the face, trunk, or limbs, walking and balance problems, bladder and/or bowel incontinence, vision problems, pain, and cognitive dysfunction, among others. Multiple sclerosis is two to three times more common in women than in men.

The University at Buffalo researchers will be testing the possibility that a condition called chronic cerebrospinal venous insufficiency (CCSVI) is the cause of multiple sclerosis symptoms. CCSVI is characterized by narrowing of the primary veins outside the skull. The narrowing of the blood vessels inhibits the normal outflow of blood from the brain, resulting in changes in the blood flow patterns within the brain, ultimately damaging brain tissue and degeneration of nerve cells.

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The current study was prompted by previous findings. In Italy, Paolo Zamboni, MD, from the University of Ferrara, discovered CCSVI and that it has a strong association with multiple sclerosis, increasing the risk of developing the disease by 43-fold. A pilot study at the Buffalo Neuroimaging Analysis Center, headed by Robert Zivadinov, MD, PhD, and director of the Center, found that abnormalities impacting the predominant pathways that transport venous blood from the brain to the heart were more common in patients with multiple sclerosis than in controls.

The new study will include 1,600 adults and 100 children who have been diagnosed with possible or definite multiple sclerosis. An additional 300 normal controls and 300 patients who have other autoimmune and neurodegenerative diseases will also be included in the study. Enrollment into the study has begun and will continue for two years. People with multiple sclerosis from across the country are invited to enroll.

Study participants will undergo a Doppler scan of the head and neck to identify venous blood flow. Patients who have multiple sclerosis will also undergo magnetic resonance imaging (MRI) of the brain to measure iron deposits in lesions. Iron is associated with neuropsychological symptoms of the disease. Researchers will also be investigating other factors that have been suggested as risk factors for multiple sclerosis, including smoking and vitamin D metabolites.

The University at Buffalo researchers believe that if their hypothesis is correct, it could allow clinicians to identify people who are at risk of getting multiple sclerosis before the disease has an opportunity to progress and cause debilitating symptoms. People who have multiple sclerosis who are interested in learning more about the study can contact the Buffalo Neuroimaging Analysis Center via e-mail at [email protected]

SOURCES:
National Multiple Sclerosis Society
University at Buffalo, Buffalo Neuroimaging Analysis Center
Zamboni P et al. Current Neurovascular Research 2009 Aug; 6(3): 204-12

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