Lo Studio Patti/Zappia (Policlinico Universitario di Catania):
I due neurologi sono sempre stati molto scettici e anti CCSVI; nonostante cio' hanno trovato CCSVI nel 18,9% nei malati di SM; ma la cosa che colpisce è la conclusione:
" Una maggiore frequenza di CCSVI è stata trovata ed era più evidente nei pazienti con SM, suggerendo che la CCSVI potrebbe essere correlata alla disabilità nella SM.
Abstract
I due neurologi sono sempre stati molto scettici e anti CCSVI; nonostante cio' hanno trovato CCSVI nel 18,9% nei malati di SM; ma la cosa che colpisce è la conclusione:
" Una maggiore frequenza di CCSVI è stata trovata ed era più evidente nei pazienti con SM, suggerendo che la CCSVI potrebbe essere correlata alla disabilità nella SM.
Abstract
Background
Chronic cerebrospinal venous insufficiency (CCSVI) has been associated to multiple sclerosis (MS).
Objective
To evaluate the possible association between CCSVI and MS, using a population-based control design.
Methods
A 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.
Results
CCSVI 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).
Conclusions
A 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.
Citation: Patti F, Nicoletti A, Leone C, Messina S, D’Amico E, et al. (2012) Multiple Sclerosis and CCSVI: A Population-Based Case Control Study. PLoS ONE 7(8): e41227. doi:10.1371/journal.pone.0041227
Editor: Ari Waisman, Johannes Gutenberg University of Mainz, Germany
Received: February 29, 2012; Accepted: June 19, 2012; Published: August 3, 2012
Copyright: © Patti et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: No external funding.
Competing interests: The authors have read the journal’s policy and have the following conflicts: Dr. F. Patti has received honoraria for speaking activities by Bayer Schering, Biogen Idec, Merck Serono, Novartis and Sanofi Aventis; he also served as advisory board member the following companies: Bayer Schering, Biogen Idec, Merck Serono, Novartis; he was also funded by Pfizer and FISM for epidemiological studies; finally he received grants for congress participation from Bayer Schering, Biogen Idec, Merck Serono, Novartis, Sanofi Aventis and TEVA. Prof. A. Nicoletti reports no competing interests. Dr. C. Leone received partial grants for congress participation from Bayer Schering and Biogen Idec. Dr. S. Messina received grants for congress participation from Bayer Schering and Merck Serono. Dr. E. D’Amico received grants for congress participation from Sanofi Aventis. Dr. S. Lo Fermo received honoraria for speaking activities from Biogen Idec, Merck Serono; he also received grants for congress participation from Bayer Schering, Biogen Idec, Merck Serono and Sanofi Aventis. Dr. V. Paradisi reports no competing interests. Dr. E. Bruno reports no competing interests. Dr. G. Quattrocchi reports no competing interests. Prof. P. F. Veroux reports no competing interests. Prof. L. Di Pino reports no competing interests. Dr. L. Costanzo reports no competing interests. Prof. M. Zappia received speaking honoraria from Biogen Idec, Merck Serono, Lilly, Sanofi Aventis; he also received grants for congress participation from the following companies: Bayer Schering, Biogen Idec, Merck Serono, Lilly, Novartis, and Sanofi Aventis; he was also funded by AIFA and MIUR. This does not alter the authors′ adherence to all the PLoS ONE policies on sharing data and materials.
Chronic cerebrospinal venous insufficiency (CCSVI) has been associated to multiple sclerosis (MS).
Objective
To evaluate the possible association between CCSVI and MS, using a population-based control design.
Methods
A 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.
Results
CCSVI 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).
Conclusions
A 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.
Citation: Patti F, Nicoletti A, Leone C, Messina S, D’Amico E, et al. (2012) Multiple Sclerosis and CCSVI: A Population-Based Case Control Study. PLoS ONE 7(8): e41227. doi:10.1371/journal.pone.0041227
Editor: Ari Waisman, Johannes Gutenberg University of Mainz, Germany
Received: February 29, 2012; Accepted: June 19, 2012; Published: August 3, 2012
Copyright: © Patti et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: No external funding.
Competing interests: The authors have read the journal’s policy and have the following conflicts: Dr. F. Patti has received honoraria for speaking activities by Bayer Schering, Biogen Idec, Merck Serono, Novartis and Sanofi Aventis; he also served as advisory board member the following companies: Bayer Schering, Biogen Idec, Merck Serono, Novartis; he was also funded by Pfizer and FISM for epidemiological studies; finally he received grants for congress participation from Bayer Schering, Biogen Idec, Merck Serono, Novartis, Sanofi Aventis and TEVA. Prof. A. Nicoletti reports no competing interests. Dr. C. Leone received partial grants for congress participation from Bayer Schering and Biogen Idec. Dr. S. Messina received grants for congress participation from Bayer Schering and Merck Serono. Dr. E. D’Amico received grants for congress participation from Sanofi Aventis. Dr. S. Lo Fermo received honoraria for speaking activities from Biogen Idec, Merck Serono; he also received grants for congress participation from Bayer Schering, Biogen Idec, Merck Serono and Sanofi Aventis. Dr. V. Paradisi reports no competing interests. Dr. E. Bruno reports no competing interests. Dr. G. Quattrocchi reports no competing interests. Prof. P. F. Veroux reports no competing interests. Prof. L. Di Pino reports no competing interests. Dr. L. Costanzo reports no competing interests. Prof. M. Zappia received speaking honoraria from Biogen Idec, Merck Serono, Lilly, Sanofi Aventis; he also received grants for congress participation from the following companies: Bayer Schering, Biogen Idec, Merck Serono, Lilly, Novartis, and Sanofi Aventis; he was also funded by AIFA and MIUR. This does not alter the authors′ adherence to all the PLoS ONE policies on sharing data and materials.
Commenti
Posta un commento