Saturday, 25 May 2013

CCSVI May

Epub: Zagaglia et al. Percutaneous transluminal angioplasty for chronic cerebrospinal venous insufficiency in multiple sclerosis: dichotomy between subjective and objective outcome scores.Neurol Sci. 2013 May.

Some multiple sclerosis (MS) patients reported an improvement after percutaneous transluminal angioplasty (PTA) for chronic cerebrospinal venous insufficiency (CCSVI), despite the lack of correspondence with objective outcome scores. The objective was to assess neurologic and quality of life scores before and after PTA for CCSVI in an observational study after a self-decided approach. 44 consecutive MS patients (21/23 M/F; median age 43 years, SD 9.8) who underwent PTA were evaluated before endovascular treatment for CCSVI and after 12 months. Neurologic outcome was assessed with EDSS, the annualized relapse rate (ARR) and frequency of new lesions at MRI after PTA. Quality of life was evaluated through the MSQoL-54 questionnaire.

No modification in the ARR (p = 0.829)

Worsening of disability status (p = 0.002) 

New lesions at MRI in 29.6 % of patients were found, in contrast to an improvement both in physical and mental domains of MSQoL-54 (p = 0.003). Multiple logistic regression showed EDSS score before PTA to be predictor of an increase of >10 points in MSQoL-54 mental domain (OR 0.52, 95 % CI, 0.31-0.89, p = 0.018). Spontaneously performed approach to CCSVI does not improve clinical and MRI parameters, despite frequent subjective perception of quality of life improvement.

Yet another negative study. CCSVI does not improve clinical and MRI parameters, despite frequent subjective perception of quality of life improvement.

The epidemic of the CCSVI meme is almost over (source Google Trends)

4 comments:

  1. I notice that CCSVI comments are left on and it's Memorial weekend...
    what could go wrong? :)

    ReplyDelete
  2. Orwell: At any given moment there is orthodoxy, a body of ideas which it is assumed that all right-thinking people will accept without question. Anyone who challenges the prevailing orthodoxy finds himself silenced with surprising effectiveness. A genuinely unfashionable opinion is almost never given a fair hearing, either in the popular press or in the highbrow periodicals.

    ReplyDelete
  3. Controvercy continues.. It such a funny thing, that if you read Neurology journals, you see negative studies and vascular journal, you see positive data. Its just wonderful that you can choose side :)
    This study was published recently and result was encouraging:

    "EDSS score was significantly improved (P<0.01) and about half of patients reported significant or mild improvement in disease status and none of them worsening of symptoms"

    http://phl.sagepub.com/content/early/2013/04/17/0268355513481766.full.pdf+html

    My wife's plasebo has lasted now 3 years, and that is just absolutely wonderful. But there is lots of work to do in research, more data is needed.

    ReplyDelete

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