PLoS ONE (Jan 2012)

Multiple sclerosis and CCSVI: a population-based case control study.

  • Francesco Patti,
  • Alessandra Nicoletti,
  • Carmela Leone,
  • Silvia Messina,
  • Emanuele D'Amico,
  • Salvatore Lo Fermo,
  • Vincenza Paradisi,
  • Elisa Bruno,
  • Graziella Quattrocchi,
  • Pierfrancesco Veroux,
  • Luigi Di Pino,
  • Luca Costanzo,
  • Mario Zappia

DOI
https://doi.org/10.1371/journal.pone.0041227
Journal volume & issue
Vol. 7, no. 8
p. e41227

Abstract

Read online

BackgroundChronic cerebrospinal venous insufficiency (CCSVI) has been associated to multiple sclerosis (MS).ObjectiveTo evaluate the possible association between CCSVI and MS, using a population-based control design.MethodsA random cohort of 148 incident MS patients were enrolled in the study. We have also studied 20 patients with clinically isolated syndrome (CIS), 40 patients with other neurological diseases (OND), and 172 healthy controls. Transcranial (TCC) and Echo Color Doppler (ECD) were carried out in 380 subjects. A subject was considered CCSVI positive if ≥2 venous hemodynamic criteria were fulfilled.ResultsCCSVI was present in 28 (18.9%) of the MS patients, in 2 (10%) of CIS patients, in 11 (6.4%) of the controls, and in 2 (5%) of the OND patients. A significant association between MS and CCSVI was found with an odds ratio of 3.41 (95% confidence interval 1.63-7.13; p = 0.001). CCSVI was significantly more frequent among MS subjects with a disease duration longer than 144 months (26.1% versus 12.6% of patients with duration shorter than 144 months; p = 0.03) and among patients with secondary progressive (SP) and primary progressive (PP) forms (30.2% and 29.4, respectively) than in patients with relapsing remitting (RR) MS (14.3%). A stronger association was found considering SP and PP forms (age adjusted OR = 4.7; 95% CI 1.83-12.0, p = 0.001); the association was weaker with the RR patients (age adjusted OR = 2.58; 95%CI 1.12-5.92; p = 0.02) or not significant in CIS group (age adjusted OR = 2.04; 95%CI 0.40-10.3; p = 0.4).ConclusionsA higher frequency of CCSVI has been found in MS patients; it was more evident in patients with advanced MS, suggesting that CCSVI could be related to MS disability.