Welcome! This blog contains research & information on lifestyle, nutrition and health for those with MS, as well as continuing information on the understanding of the endothelium and heart-brain connection. This blog is informative only--all medical decisions should be discussed with your own physicians.

The posts are searchable---simply type in your topic of interest in the search box at the top left.

Almost all of MS research is initiated and funded by pharmaceutical companies. This maintains the EAE mouse model and the auto-immune paradigm of MS, and continues the 20 billion dollar a year MS treatment industry. But as we learn more about slowed blood flow, gray matter atrophy, and environmental links to MS progression and disability--all things the current drugs do not address--we're discovering more about how to help those with MS.

To learn how this journey began, read my first post from August, 2009. Be well! Joan

Showing posts with label cerebral blood flow. Show all posts
Showing posts with label cerebral blood flow. Show all posts

Wednesday, August 20, 2014

Inadequate cerebral blood flow and loss of neurons in MS

A new study was recently been published in the JAMA Neurology journal.  One of the investigators is Yulin Ge, MD--a recent presenter at the International Society for Neurovascular Disease conference.  www.isnvd.org  Dr. Ge has been imaging the MS brain for over a decade at NYU, and he has found many vascular connections to MS.

The study looks at cerebrovascular reactivity, or CVR.  CVR is how the brain reacts or responds  with blood flow when there is vasodilation.  This function is extremely important, as neurons need adequate blood flow to provide glucose and oxygenation.  Without this response of adequate cerebral bloodflow (CBF), the brain will not function properly, and neurons can potentially die.

http://archneur.jamanetwork.com/article.aspx?articleid=1893478

What this new study did to measure CVR was to look at how healthy controls and pwMS responded to a hypercapnia (too much carbon dioxide), which the researchers created by using 5% carbon dioxide gas.  This gas increases cerebral blood flow by creating vasodilation--or a widening of blood vessels.  A healthy endothelium (lining of the blood vessels) would normally respond to hypercapnia by widening vessels and allowing for more blood to flow to the brain.

Patients with MS had a significant decrease of cerebrovascular reactivity compared with controls. This decrease in CRV correlated to gray matter atrophy, but did not correlate with white matter lesions. 

Their conclusion was that there is an impairment in the cerebrovascular pathophysiology in pwMS, and that inadequate blood flow to neurons may indeed be the cause of neurodegeneration in MS.  And that this was a vascular problem, NOT a problem initiated by white matter lesions.

We know that impaired CVR is related to arterial stenosis and occlusion of the blood vessels in the neck.  http://www.hindawi.com/journals/rrp/2012/268483/

Note that this new study did not hypothesize why this is happening in people with MS. But this study could well be related to what the Columbia researchers saw when they damaged the vascular endothelial cells outside the brain.

The Columbia University study, which was published earlier this summer, found that when researchers damaged the vascular endothelial cells lining the blood vessels outside the brain using lasers to cause oxidative stress,  they could disrupt blood flow to the brain and affect neurovascular coupling.  http://ccsviinms.blogspot.com/2014/06/columbia-researchers-provide-new.html

Dr. Zamboni has noted that there is a derangement of the endothelial cell layer in the jugular veins and valves in people with CCSVI/MS.  This loss of endothelial cell integrity could well be causing the decrease in cerebrovascular reactivity seen in people with MS.
http://phl.sagepub.com/content/early/2014/06/27/0268355514541980.abstract

As an anecdotal side note, my husband's gray matter atrophy reversed after he was treated for dural and jugular venous stenosis and began following the Endothelial Health Program.
http://ccsvi.org/index.php/helping-myself/endothelial-health
And he has had no further MS progression since 2007.

The heart and brain are connected, and a healthy endothelium is essential to both.
Something to consider,
Joan


Wednesday, June 25, 2014

The Endothelium

Update  APRIL 2019
More research continues to come in, linking endothelial dysfunction to multiple sclerosis.  Pub med has hundreds of new papers. 
https://www.ncbi.nlm.nih.gov/pubmed/?term=multiple+sclerosis+endothelial+dysfunction

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When I first began looking into how Jeff's MS was related to his vascular system in 2007,  I read many papers on pubmed which discussed the "endothelium."  A dysfunction in the lining of our blood vessels was implicated in chronic diseases of inflammation and hypoperfusion, such as MS.  I noticed that there were many modern day environmental factors that caused problems with endothelial health and blood flow.  Endothelial dysfunction was linked to diabetes, cardiovascular disease, autoimmune disease and neurodegenerative disease.  

Fast-forward seven years, and there are health stories on the endothelium in the mainstream press every day.  Here's a sampling from just last week----

Tomato Sauce helps fight heart disease   Of 36 patients with heart disease, those taking the pill every day for two months saw their blood vessels widen by 53 per cent.  This was due to improved functioning of the endothelium, the inner wall cell lining of blood vessels, scientists believe. link

How the brain regulates blood flow   Hillman found that the , the inner layer of blood vessels, plays a critical role in propagating and shaping the blood flow response to local neuronal activity. While the vascular endothelium is known to do this in other areas of the body, until now the brain was thought to use a different, more specialized mechanism and researchers in the field were focused on the cells surrounding the vessels in the brain.link
Eating Strawberries may lower blood pressure   Strawberries are rich in antioxidants, which may lower blood pressure by relaxing the endothelium, the lining inside blood vessels.  Relaxing the endothelium widens the arteries, reducing pressure.link

So, now that we know the endothelium is truly important---how is our current environment impacting our health?   And what can we do about it?
Here's what I wrote in 2007:

                                                            


I truly believe endothelial dysfunction is the disease of modern man, and is responsible for the increasing rates of chronic disease in industrialized nations.

To provide a contrast and by means of example, I present a day in the life of two women, separated by only 200 years in time.

19th Century- Life as it been lived for thousands of years-
You and your husband get up from bed as the sun rises and the rooster crows. You both get dressed and head outside together to milk the cows and feed the livestock. You work the pump at the well, get a drink of water, which comes from a fresh spring underground. The physical exertion of pumping water and carrying it, lifting the feed and milking the cows has worked up a good sweat. You gather some fresh eggs from the henhouse, and head inside to cook breakfast. The meal includes coffee or tea made with spring water, fresh milk from the cow, eggs and toast with apple preserves, jarred last fall.

The children rise, get dressed, eat and are soon out the door to walk to school. Your husband heads off to his work in the barn. There is laundry to be washed and hung on the line and gardening to do. You spend over two hours out doors, in the sunshine.  Again, hard work and more exercise. This is not a life of leisure!

Fresh fruits and vegetables are eaten in season and canned and jarred for off season.  There isnʼt much meat, but an occasional fish from the stream or chicken from the henhouse. Grains are whole, and you add flaxseed to the bread. Root vegetables and greens are plentiful. Mealtime is spent together as a family. After dinner, and after the dishes pots and pans are cleaned, the family sits together and reads or plays board games. Soon the sun sets and itʼs time for bed. Everyone is tired from the dayʼs activities and ready to sleep.

21st Century--Our Modern Life
You rise in the dark to the incessant buzz of the alarm clock. Itʼs a quick shower in chlorinated and fluoridated city water and blow dry before heading to the kitchen to make a pot of coffee. You get your water from the tap and microwave a breakfast sandwich of processed ham and cheese to go. You check your e-mail on the laptop and holler to wake your husband and the kids and hurry them up- thereʼs no time to waste! They get dressed, grab their backpacks and eat their microwaved breakfasts as everyone piles into the van.

Itʼs off to school where you drop them at the door. Then you get back on the freeway to sit in traffic. Love those fumes! Youʼre starting to get a headache. Trapped on the road, you try to make good use the time by calling clients and checking your phone. Your stress levels are now through the roof of the van. You get to the office late and have to deal with everything that has been piled on your desk. No time for the gym, and lunch is going to be a bag of peanut M&Ms and a can of Coke. You never see the light of day, except through your office windows. By the time you get home, itʼs dark and the kids are fighting over the Playstation.
You still need to make dinner. Your husband has texted you, heʼs running late and will miss dinner...again.

You pile the kids back in the van and head to a fast food place. Itʼs drive through and the kids donʼt mind. Youʼre famished and get a double cheeseburger, since you skipped lunch, how could it hurt? You get everyone home and get the kids doing their homework. Itʼs nine pm before you know it, and your husband finally gets home. He walks in and just wants to sit in front of the TV, heʼs exhausted. You get the kids bathed and into bed. Itʼs 11pm before you fall into bed, head pounding. You have trouble sleeping, and it seems like by the time you finally drift off, the damn alarm is ringing again!

I do not mean to over-romaticize or idealize the lives of men and women from centuries ago. Theirs was a very different experience, and it was physically and emotional demanding. People got sick then, very sick, and many died premature deaths. But not many suffered from chronic diseases. Our modern lifestyle is much easier in many ways-- we have automated appliances to do our labor, vehicles to transport us, and conveniences our great, great grandparents could only have dreamed of. 

Our modern lifestyle has disrupted many natural and hormonal patterns; such as the circadian rhythm. We no longer use the sun to tell us when to rise and set. And doctors are seeing a deficiency of vitamin D (the sunshine vitamin made by our skin when exposed to sunlight) linked to many diseases. Not coincidentally, lack of vitamin D is one of the causes of endothelial dysfunction.
                                                                        +++++++++++

More science continues to come in, and we've learned how endothelial dysfunction is linked to slowed cerebral blood flow and inflammation. Some of the modern lifestyle/environmental factors which have been linked to endothelial dysfunction are:

1. Lack of UV rays, low nitric oxide and low Vitamin D
2. Lack of exercise and sedentary living
3. Higher stress and cortisol release
4. Lack of REM sleep and regular circadian rhythms
5. Too much glucose and refined sugar
6. Eating transfats and processed foods
7. Toxins, pesticides and heavy metals in air and food
8. Lower intake of whole foods, fruits and vegetables

And not coincidentally, when countries become industrialized or "westernized", rates of chronic diseases rise. 

Nevertheless it was the Industrial Revolution (with the widespread use of refined vegetable oils, refined cereal grains, and refined sugars)14,65 and the Modern Age (with the advent of the “junk food” industry, generalized physical inactivity, introduction of various pollutants, avoidance of sun exposure, and reduction in sleep time and quality coupled with increased chronic psychological stress)14,38,65,146,152,153,160 that brought about the most disruptive and maladaptive changes, which may have serious pathophysiological consequences.  link

Take care of your endothelium and it will take care of you.
For more information:

Joan





Sunday, July 31, 2011


 Fasudil, cerebral blood flow and Michael J. Fox

July 31, 2011 at 1:36pm

In the news today, Michael J. Fox's foundation for Parkinson's research has awarded a grant to study a relatively new drug that improves cerebral blood flow after ischemic injury.  What is interesting is that this drug is also being studied as a treatment for MS.  This is the kind of drug that makes sense; one that helps after axonal death due to ischemia.   Let's also hope that CCSVI and the International Society for Neurovascular Disease research provides more answers for those with Parkinson's.
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GRAND RAPIDS -- Actor Michael J. Fox's foundation for Parkinson's research has awarded a $400,000 grant to fund research by Grand Rapids scientists into a drug that has the potential to halt the progression of the disease.

The focus of their efforts is Fasudil, a drug already approved in Japan to improve blood flow to the brain in stroke victims. It has shown similar positive outcomes in the U.S. in late-stage clinical trials.

Fasudil also showed potential for improving learning and memory and reducing the risk of Alzheimer's in a 2009 study by TGen and Arizona State University. VARI investigators discovered its potential for treating Parkinson's while testing drugs to reduce the toxicity caused by a gene implicated in Parkinson's disease.

"Fasudil has a very favorable safety profile in humans and is already available in Japan as an oral tablet, so upon successful milestone completion, we could be seeing clinical trials within two to three years," MacKeigan said in a statement.
http://news.msu.edu/story/9622/

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The reason it is also news for those of us in CCSVI, is because of Fasudil's affect on the endothelium, cerebral blood flow and nitric oxide.  This compound could be very helpful in recovery from brain and spinal cord injury due to CCSVI.   Here are some more studies on this drug:

Monday, March 7, 2011

Dr. Zamboni and Dr. Zivadinov's hypoperfusion study



March 7, 2011 at 1:59pm

This research was presented in April 2010 at the American Academy of Neurology conference as a poster, but we have the full paper available to us online.   Those who have read the notes on this page know that this has been an area of research near to my heart.  Hypoperfusion simply means slowed blood flow through the brain.

Here is a link to the complete paper in pdf form:


To the best of our knowledge, this pilot study is the first to report a significant relationship between the presence and severity of CCSVI and hypoperfusion in the brain parenchyma. These preliminary findings should be confirmed in a larger cohort of MS patients to ensure that they generalize to the MS population as a whole. Reduced perfusion could contribute to the known mechanisms of virtual hypoxia in degenerated axons.

 An altered CBF (cerebral blood flow) pattern may be a consequence not only of local circulatory disturbances due to inflammatory mechanisms in acute or chronic phases, but instead could result from an outflow blockage situated far away from the lesions. CCSVI is a vascular condition described in MS patients that is characterized by stenoses caused by intraluminal defects such as web, septum, malformed valve or, rarely, by segmental hypoplasia/agenesis [1,2]. Stenosing lesions of CCSVI have been classified among the truncular venous malformation in a consensus document [18,19].
Therefore, CCSVI may impact local hemodynamics and overload microcirculation at places distant fromthe location of the mechanical stenosis, as in any condition of venous obstruction of the major trunks.
Such a mechanism may lead to capillary hypertension and leakage, consistently contributing to inflammation
[20]. In this pilot study, we have shown a strong relationship between the severity of CCSVI and hypoperfusion in the WM, GM and SGM.

Please note:
All 16 pwMS had CCSVI, none of the healthy controls had CCSVI.  All pwMS had slowed cerebral blood flow, or hypoperfusion, which affected the white matter and gray matter of their brains.

100% pwMS had hypoperfusion, which was related to the severity of CCSVI.