Risk Factors for Chronic Cerebrospinal Venous Insufficiency (CCSVI) (P05.127)

Abstract

Objective: To investigate the association between presence of a newly proposed vascular condition called chronic cerebrospinal venous insufficiency (CCSVI) and environmental factors in a large volunteer control group without a known central nervous system pathology. Background The role of intra- and extra-cranial venous system impairment in the pathogenesis of various vascular, inflammatory and neurodegenerative neurological disorders, as well as in aging, has not been studied in detail. Design/Methods: The data were collected in a prospective study from 252 subjects who were screened for medical history as part of the entry criteria and participated in the case-control study of CCSVI prevalence in multiple sclerosis (MS) patients and were analyzed post hoc. All participants underwent physical and Doppler sonography examinations, and were assessed with a structured environmental questionnaire. Fullfilment of ≥ 2 positive venous hemodynamic (VH) criteria on Doppler sonography was considered indicative of CCSVI diagnosis. Risk and protective factors associated with CCSVI were analyzed using logistic regression analysis. Results: Seventy (27.8%) subjects presented with CCSVI diagnosis and 153 (60.7%) presented with one or more VH criteria. The presence of heart disease (p=.001), especially heart murmurs (p=.007), a history of infectious mononucleosis (p=.002), and irritable bowel syndrome (p=.005) were associated with more frequent CCSVI diagnosis. Current or previous smoking (p=.029) showed a trend for association with more frequent CCSVI diagnosis, while use of dietary supplements (p=.018) showed a trend for association with less frequent CCSVI diagnosis. Conclusions: Risk factors for CCSVI differ from established risk factors for peripheral venous diseases. Vascular, infectious and inflammatory factors were associated with higher CCSVI frequency. Supported by: Funded with internal resources of the Buffalo Neuroimaging Analysis Center and Baird MS Center, the Jacobs Neurological Institute, University of Buffalo. In addition, we received support from the Direct MS Foundation and the Jacquemin Foundation. Disclosure: Dr. Dolic has nothing to disclose. Dr. Weinstock-Guttman has received personal compensation for activities with Acorda Therapeutics, Biogen Idec, Serono, Inc., Novartis, Pfizer Inc, Teva Neuroscience as a speaker and/or participant on an advisory board. Dr. Weinstock-Guttman has received research support from Acorda Therapeutics, Biogen Idec, Serono Inc., Novartis, Pfizer Inc, Teva Neuroscience, National Multiple Sclerosis Society, the National Institutes of Health, ITN, Teva Neuroscience, Aspreva-Roche, Acorda Therapeutics and Shire Pharmaceuticals. Dr. Marr has nothing to disclose. Dr. Valnarov has nothing to disclose. Dr. Carl has nothing to disclose. Dr. Hagemeier has nothing to disclose. Dr. Brooks has nothing to disclose. Dr. Kilanowski has nothing to disclose. Dr. Ramanathan has received personal compensation for activities with EMD Serono, Biogen Idec, Allergan, Netezza, Pfizer, Novartis, The National Multiple Sclerosis Society, The Department of Defense, Jog for the Jake Foundation, and The National Institutes of H as a consultant.Dr. Ramanathan has received personal compensation in an editorial capacity for The American Association of Pharmaceutical Scientists.Dr. Ramanathan has received research support from EMD Serono, Biogen Idec, Allergan, Netezza, Pfizer, Novartis, The National Multiple Sclerosis Society, The Department of Defense, Jog for the Jake Foundation, and The National Institutes of H. Dr. Zivadinov has received personal compensation for activities with Teva Neuroscience, Biogen Idec, EMD Serono, and Questcor Pharmaceuticals as a speaker and/or consultant. Dr. Zivadinov has received research support from Biogen Idec, Teva Neuroscience, Genzyme Corporation, Bracco, Questcor Pharmaceuticals and EMD Serono.