, Volume 260, Issue 9, pp 2409-2410
Date: 14 Jul 2013

No evidence for CCVSI in relapsing-remitting multiple sclerosis patients with moderate disability

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Dear Sirs,

The hypothesis of chronic cerebrospinal venous insufficiency (CCSVI) as a primary cause of multiple sclerosis (MS) has been recently introduced [8]. The CCSVI might provide an explanation for the topographical relation between cerebral veins and focal demyelinating lesions, a characteristic feature of MS. The CCSVI is defined as the presence of at least two out of five ultrasound criteria such as increased reflux from vertebral veins or deep cerebral veins [1, 8, 9]. The initial study on CCSVI in patients with relapsing-remitting and progressive MS with moderate to severe disability suggested that CCSVI occurs in up to 100 % of patients and that is not present in healthy controls at all [8]. There have been a number of attempts to reproduce these findings, some studies see a correlation between impaired venous outflow and MS [5, 10], in other studies there is no association at all [2, 3]. The CCSVI has not caused a major paradigm change for MS yet. The aim of the study was to