Dr. Dario Alpini overleden
[URL="http://www.pagepressjournals.org/index. ... /6851/6548"][U]Dario Alpini[/U][/URL], a pioneer of venous and lymphatics disorders of the inner ear
[QUOTE]Dario dedicated most of his scientific work exploring the causes that provoked dizziness and vertigo and more recently joined with enthusiasm all the research that regarded chronic cerebrovascular venous insufficiency (CCSVI) finding and bridging, as he used to say, the gap between Ménière’s disease and multiple sclerosis. [/QUOTE]
CCSVI-10
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Marsei
Alfred trial in Australie wordt voortgezet
Alfred trial in Australie wordt voortgezet
Van Kerri: [QUOTE]The great news that was confirmed at the ISNVD conference in Sicily last month is that the Alfred trial is continuing! The cogs have started turning again as the next cohort enter the trial this year. [/QUOTE]
Van Kerri: [QUOTE]The great news that was confirmed at the ISNVD conference in Sicily last month is that the Alfred trial is continuing! The cogs have started turning again as the next cohort enter the trial this year. [/QUOTE]
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Marsei
Verslag Kerri ISNVD congres
Verslag Kerri ISNVD congres
[URL="http://ccsviaustralia.com.au/isnvd_2017 ... ng_Project"][U]ISNVD Scientific Meeting 2017[/U][/URL]
[URL="http://ccsviaustralia.com.au/isnvd_2017 ... ng_Project"][U]ISNVD Scientific Meeting 2017[/U][/URL]
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Marsei
Measurement of jugular foramen diameter using MRI
Measurement of jugular foramen diameter using MRI
Measurement of [URL="https://link.springer.com/article/10.11 ... 017-0008-3"][U]jugular foramen diameter[/U][/URL] using MRI in multiple sclerosis patients compared to control subjects
[QUOTE][B]Abstract[/B]
[B]Background[/B]
Multiple sclerosis (MS) is a chronic disease of the central nervous system. As an association between MS and reduced cerebral venous blood drainage was hypothesised, our aim was to compare the size of the jugular foramina in patients with MS and in control subjects.
[B]Methods[/B]
Ethics committee approval was received for this retrospective case–control study. We collected imaging and clinical data of 53 patients with MS (23 men, mean age 45 ± 9 years) and an age/gender-matched control group of 53 patients without MS (23 men, mean age 46 ± 10 years). The minimal diameter of both jugular foramina was measured on T1-weighted contrast-enhanced axial magnetic resonance images; the two diameters were summed. Student t test and Spearman correlation coefficient were used for analysis. Reproducibility was estimated using the Bland–Altman method.
[B]Results[/B]
The mean diameter of the right foramen in patients with MS (6.3 ± 1.6 mm) was 10% smaller than that of the controls (7.0 ± 1.4 mm) (p = 0.020); the mean diameter of the left foramen in patients with MS (5.6 ± 1.3 mm) was 7% smaller than that of the controls (6.0 ± 1.3 mm) (p = 0.089). The sum of the diameters of both jugular foramina in patients with MS (mean 11.9 ± 2.3 mm) was 8% smaller (p = 0.009) than that of the controls (mean 13.0 ± 2.1 mm). The differences in diameters between patients with relapsing-remitting MS and patients with secondary progressive MS were not significant (p ≥ 0.332). There was no significant correlation between foramen diameters and the expanded disability status scale (p ≥ 0.079). Intra-reader and inter-reader reproducibility were 91% and 88%, respectively.
[B]Conclusions[/B]
Jugular foramen diameter in patients with MS was 7-10% smaller than that in controls, regardless of the MS disease course.[/QUOTE]
Measurement of [URL="https://link.springer.com/article/10.11 ... 017-0008-3"][U]jugular foramen diameter[/U][/URL] using MRI in multiple sclerosis patients compared to control subjects
[QUOTE][B]Abstract[/B]
[B]Background[/B]
Multiple sclerosis (MS) is a chronic disease of the central nervous system. As an association between MS and reduced cerebral venous blood drainage was hypothesised, our aim was to compare the size of the jugular foramina in patients with MS and in control subjects.
[B]Methods[/B]
Ethics committee approval was received for this retrospective case–control study. We collected imaging and clinical data of 53 patients with MS (23 men, mean age 45 ± 9 years) and an age/gender-matched control group of 53 patients without MS (23 men, mean age 46 ± 10 years). The minimal diameter of both jugular foramina was measured on T1-weighted contrast-enhanced axial magnetic resonance images; the two diameters were summed. Student t test and Spearman correlation coefficient were used for analysis. Reproducibility was estimated using the Bland–Altman method.
[B]Results[/B]
The mean diameter of the right foramen in patients with MS (6.3 ± 1.6 mm) was 10% smaller than that of the controls (7.0 ± 1.4 mm) (p = 0.020); the mean diameter of the left foramen in patients with MS (5.6 ± 1.3 mm) was 7% smaller than that of the controls (6.0 ± 1.3 mm) (p = 0.089). The sum of the diameters of both jugular foramina in patients with MS (mean 11.9 ± 2.3 mm) was 8% smaller (p = 0.009) than that of the controls (mean 13.0 ± 2.1 mm). The differences in diameters between patients with relapsing-remitting MS and patients with secondary progressive MS were not significant (p ≥ 0.332). There was no significant correlation between foramen diameters and the expanded disability status scale (p ≥ 0.079). Intra-reader and inter-reader reproducibility were 91% and 88%, respectively.
[B]Conclusions[/B]
Jugular foramen diameter in patients with MS was 7-10% smaller than that in controls, regardless of the MS disease course.[/QUOTE]
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zeiler
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Marsei
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zeiler
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Marsei
New research: MS as a disease of Endothelial Dysfunction
New research: MS as a disease of Endothelial Dysfunction
[URL="http://ccsviinms.blogspot.nl/2015/07/ne ... f.html?m=1"][U]Blog Joan[/U][/URL]: New research: MS as a disease of Endothelial Dysfunction
[QUOTE]We have a brand new peer-reviewed paper from the researchers of the ISNVD which is considering the vascular connection to MS. It is called:
"Blood circulating microparticle species in relapsing–remitting and secondary progressive multiple sclerosis. A case–control, cross sectional study with conventional MRI and advanced iron content imaging outcomes" This paper is published in the Journal of Neurological Sciences.[/QUOTE]
[QUOTE]The researchers looked at serum markers of healthy individuals and compared them to people with MS. [/QUOTE]
[QUOTE]What they found were that [B]in people with MS, there are circulating microparticles in the blood that aren't found in healthy people.[/B] These markers (CD31+/CD51+/CD61+/CD54+) are microparticles which are shed from the lining of the damaged endothelium. [B]We see the same markers in cardiovascular disease.[/B] These markers are associated with coronary artery disease, hypercoagulation, thrombosis (clotting) and stroke. [/QUOTE]
[QUOTE]Endothelial microparticles (EMP) are shed by dying and injured endothelial cells. They cause hypercoagulation, inflammation and contribute to vascular disease. They slow blood flow.[/QUOTE]
[QUOTE][B]These markers were shown to be correlated with lesions and brain atrophy in MS using SWI and MRI scans.[/B]
Here is the conclusion from the researchers: These results indicate that circulating microparticles' profiles in MS may support mechanistic roles for microvascular stress and injury which is an underlying contributor not only to MS initiation and progression, but also to pro-inflammatory responses.
This means that stress and injury to the endothelial lining, also known as endothelial dysfunction, may be a contributor to MS initiation and progression.
[B]The good news is that there are things we can all do today to reduce endothelial dysfunction, cellular stress and injury and bring these serum markers down. [/B] The hope is that by helping the endothelium heal, we can limit microparticle shedding into the blood, and reverse this inflammatory process.[/QUOTE]
[URL="http://ccsviinms.blogspot.nl/2015/07/ne ... f.html?m=1"][U]Blog Joan[/U][/URL]: New research: MS as a disease of Endothelial Dysfunction
[QUOTE]We have a brand new peer-reviewed paper from the researchers of the ISNVD which is considering the vascular connection to MS. It is called:
"Blood circulating microparticle species in relapsing–remitting and secondary progressive multiple sclerosis. A case–control, cross sectional study with conventional MRI and advanced iron content imaging outcomes" This paper is published in the Journal of Neurological Sciences.[/QUOTE]
[QUOTE]The researchers looked at serum markers of healthy individuals and compared them to people with MS. [/QUOTE]
[QUOTE]What they found were that [B]in people with MS, there are circulating microparticles in the blood that aren't found in healthy people.[/B] These markers (CD31+/CD51+/CD61+/CD54+) are microparticles which are shed from the lining of the damaged endothelium. [B]We see the same markers in cardiovascular disease.[/B] These markers are associated with coronary artery disease, hypercoagulation, thrombosis (clotting) and stroke. [/QUOTE]
[QUOTE]Endothelial microparticles (EMP) are shed by dying and injured endothelial cells. They cause hypercoagulation, inflammation and contribute to vascular disease. They slow blood flow.[/QUOTE]
[QUOTE][B]These markers were shown to be correlated with lesions and brain atrophy in MS using SWI and MRI scans.[/B]
Here is the conclusion from the researchers: These results indicate that circulating microparticles' profiles in MS may support mechanistic roles for microvascular stress and injury which is an underlying contributor not only to MS initiation and progression, but also to pro-inflammatory responses.
This means that stress and injury to the endothelial lining, also known as endothelial dysfunction, may be a contributor to MS initiation and progression.
[B]The good news is that there are things we can all do today to reduce endothelial dysfunction, cellular stress and injury and bring these serum markers down. [/B] The hope is that by helping the endothelium heal, we can limit microparticle shedding into the blood, and reverse this inflammatory process.[/QUOTE]
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Marsei
Centralized and local color Doppler ultrasound reading agreement
Centralized and local color Doppler ultrasound reading agreement
Tweet Zamboni:
[QUOTE]"Increased jugular size in upright and flow blockage are reproducible #CCSVI biomarkers in #MultipleSclerosis"
"To Screen #CCSVI by ECD with trained local and central readers @ISNVD It works"[/QUOTE]
[URL="https://www.ncbi.nlm.nih.gov/m/pubmed/28721810/"][U]Centralized and local color Doppler ultrasound reading agreement [/U][/URL]for diagnosis of the chronic cerebrospinal venous insufficiency in patients with Multiple Sclerosis.
[B]Abstract[/B]
[QUOTE][B]BACKGROUND[/B]: An impaired cerebrospinal venous drainage was postulated to be a cofactor in the multifactorial pathogenesis of multiple sclerosis (MS). Chronic cerebrospinal venous insufficiency (CCSVI) is characterized by abnormalities of the main extracranial cerebrospinal venous outflow routes, which can be detected by color Doppler Ultrasound (CDUS) using 5 venous hemodynamic (VH) criteria. Discrepant results between different investigators were reported in the past, therefore the usefulness and applicability of the CCSVI CDUS-based diagnosis in clinical research and practice has been questioned. The reproducibility of proposed criteria for CCSVI detection depends on the blinding, training level, skills of the operator and interpretation of VH criteria.
[B]OBJECTIVES[/B]: To assess agreement between centralized and local reading of CDUS examination for diagnosis of CCSVI in trained Doppler sonologists.
[B]METHODS[/B]: This study was performed in 78 MS patients and 28 age- and sex-matched healthy controls (HCs). Extracranial and transcranial CDUS venous hemodynamic assessment was conducted, according to International Society of Neurovascular Disease recommended criteria, by a single CCSVI-trained expert sonologist blinded to the subject disease status. After the local Doppler sonologist performed the investigation, all images and video clips of the CDUS examination were sent to the centralized reading center, where a second blinded reading was performed by two CCSVI-trained expert sonologists. Statistical analyses were performed comparing accuracy of CCSVI diagnosis (≥2 VH criteria) and each of the 5 individual VH criteria using Cohen kappa statistic, along with positive/negative agreement and Odds ratio (OR) with 95% confidence intervals (95% CI).
[B]RESULTS[/B]: Diagnosis of CCSVI was obtained in 59.7% of local and 64.3% centralized readers (Kappa, 0.67, p<0.001). Similar Kappa values were obtained for CCSVI diagnosis and individual CCSVI criteria in both MS patients and HCs. The highest Kappa between local and centralized readers was observed for VH criteria 5 (0.93) followed by VH criteria 4 (0.70), VH criteria 1 (0.66), VH criteria 2 (0.64) and VH criteria 3 (0.58). The positive predictive value (PPV) and negative predictive value (NPV) for CCSVI diagnosis was 82.7% and 86,7%, respectively with an OR of 31.1 (95% CI 11.1-87.5, p<0.001). The highest agreement between local and centralized readers was observed for VH criteria 4 (OR 98.7, 95% CI 17.1-569.9, p<0.001) with 72.7% PPV and 97.3% NPV followed by VH criteria 5 (53, 95% CI 13.4-209.2, p<0.001) with 98.1% PPV and 100% NPV value.
[B]CONCLUSIONS[/B]: Centralized reading of the CDUS examination for the diagnosis of CCSVI is feasible with high accuracy in CCSVI-trained Doppler sonologists. The most reproducible VH criteria between local and centralized readers were VH criteria 4 and 5.[/QUOTE]
Tweet Zamboni:
[QUOTE]"Increased jugular size in upright and flow blockage are reproducible #CCSVI biomarkers in #MultipleSclerosis"
"To Screen #CCSVI by ECD with trained local and central readers @ISNVD It works"[/QUOTE]
[URL="https://www.ncbi.nlm.nih.gov/m/pubmed/28721810/"][U]Centralized and local color Doppler ultrasound reading agreement [/U][/URL]for diagnosis of the chronic cerebrospinal venous insufficiency in patients with Multiple Sclerosis.
[B]Abstract[/B]
[QUOTE][B]BACKGROUND[/B]: An impaired cerebrospinal venous drainage was postulated to be a cofactor in the multifactorial pathogenesis of multiple sclerosis (MS). Chronic cerebrospinal venous insufficiency (CCSVI) is characterized by abnormalities of the main extracranial cerebrospinal venous outflow routes, which can be detected by color Doppler Ultrasound (CDUS) using 5 venous hemodynamic (VH) criteria. Discrepant results between different investigators were reported in the past, therefore the usefulness and applicability of the CCSVI CDUS-based diagnosis in clinical research and practice has been questioned. The reproducibility of proposed criteria for CCSVI detection depends on the blinding, training level, skills of the operator and interpretation of VH criteria.
[B]OBJECTIVES[/B]: To assess agreement between centralized and local reading of CDUS examination for diagnosis of CCSVI in trained Doppler sonologists.
[B]METHODS[/B]: This study was performed in 78 MS patients and 28 age- and sex-matched healthy controls (HCs). Extracranial and transcranial CDUS venous hemodynamic assessment was conducted, according to International Society of Neurovascular Disease recommended criteria, by a single CCSVI-trained expert sonologist blinded to the subject disease status. After the local Doppler sonologist performed the investigation, all images and video clips of the CDUS examination were sent to the centralized reading center, where a second blinded reading was performed by two CCSVI-trained expert sonologists. Statistical analyses were performed comparing accuracy of CCSVI diagnosis (≥2 VH criteria) and each of the 5 individual VH criteria using Cohen kappa statistic, along with positive/negative agreement and Odds ratio (OR) with 95% confidence intervals (95% CI).
[B]RESULTS[/B]: Diagnosis of CCSVI was obtained in 59.7% of local and 64.3% centralized readers (Kappa, 0.67, p<0.001). Similar Kappa values were obtained for CCSVI diagnosis and individual CCSVI criteria in both MS patients and HCs. The highest Kappa between local and centralized readers was observed for VH criteria 5 (0.93) followed by VH criteria 4 (0.70), VH criteria 1 (0.66), VH criteria 2 (0.64) and VH criteria 3 (0.58). The positive predictive value (PPV) and negative predictive value (NPV) for CCSVI diagnosis was 82.7% and 86,7%, respectively with an OR of 31.1 (95% CI 11.1-87.5, p<0.001). The highest agreement between local and centralized readers was observed for VH criteria 4 (OR 98.7, 95% CI 17.1-569.9, p<0.001) with 72.7% PPV and 97.3% NPV followed by VH criteria 5 (53, 95% CI 13.4-209.2, p<0.001) with 98.1% PPV and 100% NPV value.
[B]CONCLUSIONS[/B]: Centralized reading of the CDUS examination for the diagnosis of CCSVI is feasible with high accuracy in CCSVI-trained Doppler sonologists. The most reproducible VH criteria between local and centralized readers were VH criteria 4 and 5.[/QUOTE]