Mededelingen over chronische cerebro-spinale veneuze insufficiëntie (CCSVI)

  Source: The Lancet Neurology Copyright © 2011 Elsevier BV (21/06/11)

Three types of vascular dysfunction have been described in multiple sclerosis (MS).

First, findings from epidemiological studies suggest that patients with MS have a higher risk for ischaemic stroke than people who do not have MS. The underlying mechanism is unknown, but might involve endothelial dysfunction secondary to inflammatory disease activity and increased plasma homocysteine concentrations.

Second, patients with MS have global cerebral hypoperfusion, which might predispose them to the development of ischaemic stroke. The widespread decrease in perfusion in normal-appearing white matter and grey matter in MS seems not to be secondary to axonal degeneration, but might be a result of reduced axonal activity, reduced astrocyte energy metabolism, and perhaps increased blood concentrations of endothelin-1. Data suggest that a subtype of focal MS lesions might have an ischaemic origin, and there seems to be a link between reduced white matter perfusion and cognitive dysfunction in MS.

Third, the pathology of MS might be the consequence of a chronic state of impaired venous drainage from the CNS, for which the term chronic cerebrospinal venous insufficiency (CCSVI) has been coined. A number of recent vascular studies do not support the CCSVI theory, but some elements of CCSVI might be explained by slower cerebral venous blood flow secondary to the reduced cerebral perfusion in patients with MS compared with healthy individuals.

Update: Oktober 2010 

Ingevolge nieuwe recente studies, communiceert de Medische Adviesraad van de Belgische MS-Liga volgend bericht  

Mededeling MSIF:

geplaatst op 9 juni 2010

Chronic Cerebrospinal Venous Insufficiency (CCSVI)  (document in het engels)

Mededeling Medische Adviesraad Nationaal MS-Liga:

geplaatst op 16 februari 2010

De Medische Adviesraad van de Nationale Belgische MS-Liga heeft kennis genomen van de studies over chronische cerebro-spinale veneuze insufficiëntie (CCVSI) en de relatie met MS.   De Raad is van mening dat bijkomende onafhankelijke studies eerst moeten worden gevoerd die deze hypothese bevestigen alvorens aan een therapeutische aanpak kan gedacht worden.  Bij haar weten wordt er op dit ogenblik geen diepgaand onderzoek gevoerd in deze materie in België. De Liga zal verdere informatie over dit onderwerp publiceren van zodra er nieuwe elementen zijn.