Alice in Wonderland and CCSVI

Will the following Editorial put the CCSVI issue to rest? #MSBlog #MSResearch

Michael Rasminsky & Karel ter Brugge. Goodbye to all that: a short history of CCSVI. Multiple Sclerosis Journal 2013; 19(11) 1425–1427.


Excerpts:  

Alice laughed: “There’s no use trying,” she said; “one can’t believe impossible things.” “I daresay you haven’t had much practice,” said the Queen. “When I was younger, I always did it for half an hour a day. Why, sometimes I’ve believed as many as six impossible things before breakfast.”

Lewis Carroll, Alice in Wonderland


.....  The current issue of the MS Journal contains carefully performed studies by the group from the University of Texas and by the Italian CoSMo Collaborative Study Group that together with the previous study by the Texas group will hopefully finally definitively put paid to the hypothesis that multiple sclerosis (MS) is caused by chronic cerebrospinal venous insufficiency (CCSVI). It could be argued that such studies would have been unnecessary in a rational society, but they were unfortunately absolutely required in the hyper-connected society in which we live.

In the last 4 years the CCSVI hypothesis has turned the MS world upside down. The initial report of venous abnormalities in MS purported to demonstrate that 100% of individuals with MS had significant constrictions of veins draining the brain. This quickly and logically led to attempts to correct the abnormality by vein dilation and/or stenting. Elements of the media, ever anxious for a heartwarming story of a new and simple solution to a tragic problem that has played havoc with many lives, quickly trumpeted the story of the intrepid Italian investigator who had invented an enticingly labeled “liberation procedure” for the treatment of MS.6,7

From the outset there was healthy skepticism in the neurologic community. Not only did the contention that a venous anomaly was present in 100% of individuals with MS send up red flags, but the theory that a venous anomaly, even if indeed present, could cause MS …

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