How does the new gray matter research apply to CCSVI?

December 8, 2011 at 10:21am

If you haven't read yesterday's rather paradigm-shifting news about MS and the gray matter, look down a couple of posts.

In a nutshell--researchers from the Cleveland Clinic,  Mayo Clinic, and also Yale- have come forward with new evidence that confirms decades worth of research showing that MS is not primarily an autoimmune disease of the white matter, it is first a disease of gray matter.

The researchers admit that they do not know how current disease modifying drugs address cortical brain damage, and there are no current therapies created for this purpose.  This is most likely why MS disease progression continues while patients are on the drugs, even though relapse numbers may be diminished.  This is why gray matter atrophy is the biomarker for MS disease progression.

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 How does that fit in with Dr. Zamboni's discovery?  

The gray matter uses 94% of the brain's oxygen supply.  Because of this, gray matter is especially sensitive to any low oxygen environment.

The gray matter is densly packed with blood delivering capillaries.  The blood is what gives gray matter it's color and density.  Any endothelial dysfunction in this region can increase the risk of damage.  Any refluxive flow, break in the blood brain barrier, any iron or heme deposition into brain tissue from microvascular leakage, can affect this part of our brain and create inflammation.

In other words---adequate blood flow and perfusion is essential in this area of the brain.  For delivery of nutrients and oxygen, for removal of waste, for shear stress to maintain a healthy blood brain barrier.  Venous insufficiency and reflux is disasterous to the gray matter and can create inflammation.

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Many of the doctors involved in CCSVI research (Haacke, Hubbard, Dake) have written about the deep cerebral drainage of the cortex, and how this can be impacted by venous insufficiency.

 Let's go to Dr. Zamboni, the man who discovered CCSVI and understands blood flow---

Dr. Zamboni has found reflux in the deep cerebral veins which drain the gray matter of the brain.

The intracranial venous system is mainly composed of parenchymal veins draining into the dural sinuses. The former can be subdivided into two systems:1,2

• The superficial (cortical) system reaches dural sinuses by cortical veins and drains blood mainly from cortex and subcortical white matter;
• The deep cerebral venous system (DCVs) is composed by the internal cerebral veins, the basal vein of Rosenthal and the great cerebral vein of Galen and their tributaries, and drains the deep white and gray matter surrounding the lateral and third ventricles.

The cerebral veins collect blood into the dural sinuses and in turn redirected toward the main extracranial venous outflow routes: the internal jugular veins (IJVs) and the vertebral veins (VVs) system (Figure 1). The anatomical pathways of jugular drainage are well established. The main jugular blood drainage pathway leads from the transverse sinuses via the sigmoid sinuses into the IJVs, which meet the superior cava vein via the brachiocephalic vein. Valve fractioning of the blood column is possible only at the distal portion of the IJVs, where valves were found in 93% of post-mortem studies, and in 87% of Bmode investigations, mainly on the right side.3

Cerebral vein hemodynamics in healthy subjects are characterized by a laminar, mono-directional flow with low velocity, and it has been established that steady laminar stress promotes a release of factors from endothelial cells that inhibit migration of leukocytes.  

In contrast.....Refluxing oscillatory flow favours expression of adhesion molecules on endothelial cells, becoming a previously overelooked inflammatory mechanism in MS.  

http://phleb.rsmjournals.com/content/25/6/269.full

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I might like to suggest that instead of continuing down the road of immunology, trying to force the immune system theory of MS make sense--that MS researchers admit they need to look at the mechanism of blood flow.   I know a few vascular doctors who would be willing to work with you.

But what really hurt this morning was the thought that all over the world today, people are being diagnosed with MS.  They are being told it's an autoimmune disease of the white matter.  Their doctors are handing them the glossy pharma brochures and asking them to choose their medicine.  The very same medicines that Dr. Lucchinetti mentioned in her video yesterday, which, she stated, do not address the gray matter damage, or MS progression.   

My only hope is that the newly diagnosed get online and find the research of Dr. Zamboni, Dr. Hubbard, Dr. Embry, Dr. Wahls, Dr. Jelinek, Dr. Swank and the host of other researchers discussing lifestyle, diet, nutrition and blood flow.

Because after 70 + years of the tyranny of the EAE mouse model, we are finally getting somewhere.

Joan