CCSVI Research Vancouver Diagnostics Centre

Purpose of the Study

Recently it has been suggested that the blood vessels that return blood from the brain to the heart (veins) are abnormal in individuals with Multiple Sclerosis. While it has been demonstrated that there may be flow disruption in those with Multiple Sclerosis, it needs to be quantified and compared to a population who do not have Multiple Sclerosis.

About the CCSVI Blood Flow Study

We now have advanced imaging techniques for the brain, involving MRI that are capable of measuring blood flow using contrast MRI flow quantifications (FQ) techniques that can measure flow. With this technology blood flow both into and out of the brain can be measured with some precision.

Magnetic resonance imaging (MRI or MR) is a medical imaging method where high magnetic fields are used to obtain precise images of the inside of the human body without x-rays. The magnetic field causes protons (sub-atomic particles) in the body to align in one direction. A radiofrequency signal (like a radio wave) is turned on briefly, causing the protons to rotate: as they rotate back to the original alignment, a signal is produced that can be measured and used to construct images. The MRI scanner is a large hollow cylinder (sometimes called a “doughnut”). The person being scanned lies on a bed which moves into the scanner. As the equipment turns on and off very quickly, the scanner makes a variety of noises. Patients will be given ear protection and will be asked to lie very still, as movement affects the images (like moving objects blur in photographs). Because it can image soft tissues so well, MRI is often used to diagnose injuries or illnesses of the brain, heart, blood vessels, spinal cord, internal organs and major joints. We will be taking images of the blood vessels associated with the brain. MRI imaging is considered safe and there is no radiation involved in MRI scanning.

Contrast enhanced MR venography is now widely regarded as the optimal method for evaluating veins and arteries in the brain. The current contrast in use is called gadolinium and is non-invasive and relatively safe when compared to older contrast such as iodinated contrast. Its use should be avoided in anyone with poor kidney function. All patients in this study will have their kidney function assessed before enrollment.

Qualifications

• Participant is 19 years or older
• Participant has MS for less than 10 years OR be a match in age or gender to someone with MS
• Participant without Multiple Sclerosis, has no close relatives with Multiple Sclerosis
• Participant has normal kidney function

Obligations

• MRI exam of the vessels in the brain
• Blood test to test kidney function
• A total time commitment of about 3 hours

Research Doctors

The study doctor of this study is Dr. G. Keith Chambers; sub-investigators are Dr. Mark Godley and Dr. Tim Meakin. The study doctors are all affiliated with the False Creek Healthcare Centre.

This study is not funded by any commercial interests. None of the study doctors have received any funds for their involvement, and the MRI technology is being provided by the Centre.

CCSVI Background

Multiple Sclerosis is a disorder of unknown origin.

It has been recently suggested that the blood vessels that return blood from the brain to the heart (veins) are abnormal in MS, and that there are abnormally high levels of metals such as iron in the brains of Multiple Sclerosis patients. Recently, a researcher in Italy (Dr. Zamboni) has proposed that the iron overload occurs when there is venous “backflow”. Technically, this is called Chronic Cerebrospinal Venous Insufficiency (CCSVI). This has led to the use of invasive techniques to treat this backflow, despite the absence of scientific studies.