期刊
NEUROLOGY
卷 77, 期 2, 页码 138-144出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e318212a901
关键词
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资金
- Buffalo Neuroimaging Analysis Center
- Baird MS Center
- Jacobs Neurological Institute
- University of Buffalo
- Direct MS Foundation
- Jacquemin Family Foundation
- Millenium Pharmaceuticals, Inc.
- Klein Buendel, Inc.
- Alexion Pharmaceuticals, Inc.
- Androclus Therapeutics, Inc.
- University of Illinois
- Amgen
- New York University
- Somnus Therapeutics, Inc.
- ApopLogic Pharmaceuticals
- LLC
- NIH [NINDS 5U01NS042685-02 [PI], 3R01DC004689-08S1, R01 NS062820-01A2]
- NINDS [U01 NS45719-01A1]
- NIAID [HHSN266200400068C, N01AI30025, P30AI27767]
- NHLBI [5R01 HL06991-02, 5P50HL084923-030001]
- NIDR [3R01DE016684-03S109]
- NIDDK [1R01DK078826, 1P30DK079337]
- Consortium of Multiple Sclerosis Centers (Director NARCOMS Data Center)
- National Multiple Sclerosis Society
- EMD Serono, Inc.
- Novartis
- Pfizer Inc.
- Biogen Idec
- US Department of Defense
- Shire plc
- Jog for the Jake
- Children's Guild Foundation
- National MS Society
- Teva Pharmaceutical Industries Ltd.
- Cyberonics, Inc.
Background: Chronic cerebrospinal venous insufficiency (CCSVI) was recently described in patients with multiple sclerosis (MS). A subject is considered CCSVI positive if >= 2 venous hemodynamic (VH) criteria are fulfilled. Objective: To determine prevalence of CCSVI in a large cohort of patients with MS, clinically isolated syndrome (CIS), other neurologic diseases (OND), and healthy controls (HC), using specific proposed echo-color Doppler (ECD) criteria. Methods: Transcranial and extracranial ECD were carried out in 499 enrolled subjects (289 MS, 163 HC, 26 OND, 21 CIS). Prevalence rates for CCSVI were calculated in 3 ways: first, using only the subjects for whom diagnosis was certain (i.e., borderline subjects were excluded); secondly, including the borderline subjects in the no CCSVI group; and finally, taking into account subjects who presented any of the VH criteria. Results: CCSVI prevalence with borderline cases included in the no CCSVI group was 56.1% in MS, 42.3% in OND, 38.1% in CIS, and 22.7% in HC (p < 0.001). The CCSVI prevalence figures were 62.5% for MS, 45.8% for OND, 42.1% for CIS, and 25.5% for HC when borderline cases were excluded (p < 0.001). The prevalence of one or more positive VH criteria was the highest in MS (81.3%), followed by CIS (76.2%), OND (65.4%), and HC (55.2%) (p < 0.001). CCSVI prevalence was higher in patients with progressive than in nonprogressive MS (p = 0.004). Conclusions: Our findings are consistent with an increased prevalence of CCSVI in MS but with modest sensitivity/specificity. Our findings point against CCSVI having a primary causative role in the development of MS. Neurology(R) 2011;77:138-144
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