No association between variations in extracranial venous anatomy and clinical outcomes in multiple sclerosis patients over 5 years
Abstract Background No longitudinal, long-term, follow-up studies have explored the association between presence and severity of variations in extracranial venous anatomy, and clinical outcomes in patients with multiple sclerosis (MS). Objective This prospective 5-year follow-up study assessed the r...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-06-01
|
| Series: | BMC Neurology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12883-019-1350-2 |
| _version_ | 1818292858826784768 |
|---|---|
| author | Sirin Gandhi Karen Marr Marcello Mancini Maria Grazia Caprio Dejan Jakimovski Avinash Chandra Jesper Hagemeier David Hojnacki Channa Kolb Bianca Weinstock-Guttman Robert Zivadinov |
| author_facet | Sirin Gandhi Karen Marr Marcello Mancini Maria Grazia Caprio Dejan Jakimovski Avinash Chandra Jesper Hagemeier David Hojnacki Channa Kolb Bianca Weinstock-Guttman Robert Zivadinov |
| author_sort | Sirin Gandhi |
| collection | DOAJ |
| description | Abstract Background No longitudinal, long-term, follow-up studies have explored the association between presence and severity of variations in extracranial venous anatomy, and clinical outcomes in patients with multiple sclerosis (MS). Objective This prospective 5-year follow-up study assessed the relationship of variations in extracranial venous anatomy, indicative of chronic cerebrospinal venous insufficiency (CCSVI) on Doppler sonography, according to the International Society for Neurovascular Disease (ISNVD) proposed consensus criteria, with clinical outcomes and disease progression in MS patients. Methods 90 MS patients (52 relapsing-remitting, RRMS and 38 secondary-progressive, SPMS) and 38 age- and sex-matched HIs were prospectively followed for 5.5 years. Extracranial and transcranial Doppler-based venous hemodynamic assessment was conducted at baseline and follow-up to determine the extent of variations in extracranial venous anatomy. Change in Expanded Disability Status Scale (∆EDSS), development of disability progression (DP) and annualized relapse rate (ARR) were assessed. Results No significant differences were observed in MS patients, based on their presence of variations in extracranial venous anatomy at baseline or at the follow-up, in ∆EDSS, development of DP or ARR. While more MS patients had ISNVD CCSVI criteria fulfilled at baseline compared to HIs (58% vs. 37%, p = 0.03), no differences were found at the 5-year follow-up (61% vs. 56%, p = 0.486). Discussion This is the longest follow-up study assessing the longitudinal relationship between the presence of variations in extracranial venous anatomy and clinical outcomes in MS patients. Conclusion: The presence of variations in extracranial venous anatomy does not influence clinical outcomes over the 5-year follow-up in MS patients. |
| first_indexed | 2024-12-13T03:06:39Z |
| format | Article |
| id | doaj.art-7a253cb3fa7842fda1d4de46bd669328 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-13T03:06:39Z |
| publishDate | 2019-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-7a253cb3fa7842fda1d4de46bd6693282022-12-22T00:01:42ZengBMCBMC Neurology1471-23772019-06-011911910.1186/s12883-019-1350-2No association between variations in extracranial venous anatomy and clinical outcomes in multiple sclerosis patients over 5 yearsSirin Gandhi0Karen Marr1Marcello Mancini2Maria Grazia Caprio3Dejan Jakimovski4Avinash Chandra5Jesper Hagemeier6David Hojnacki7Channa Kolb8Bianca Weinstock-Guttman9Robert Zivadinov10Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New YorkBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New YorkInstitute of Biostructure and Bioimaging, National Research Council of ItalyInstitute of Biostructure and Bioimaging, National Research Council of ItalyBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New YorkBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New YorkBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New YorkJacobs Multiple Sclerosis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New YorkJacobs Multiple Sclerosis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New YorkJacobs Multiple Sclerosis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New YorkBuffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New YorkAbstract Background No longitudinal, long-term, follow-up studies have explored the association between presence and severity of variations in extracranial venous anatomy, and clinical outcomes in patients with multiple sclerosis (MS). Objective This prospective 5-year follow-up study assessed the relationship of variations in extracranial venous anatomy, indicative of chronic cerebrospinal venous insufficiency (CCSVI) on Doppler sonography, according to the International Society for Neurovascular Disease (ISNVD) proposed consensus criteria, with clinical outcomes and disease progression in MS patients. Methods 90 MS patients (52 relapsing-remitting, RRMS and 38 secondary-progressive, SPMS) and 38 age- and sex-matched HIs were prospectively followed for 5.5 years. Extracranial and transcranial Doppler-based venous hemodynamic assessment was conducted at baseline and follow-up to determine the extent of variations in extracranial venous anatomy. Change in Expanded Disability Status Scale (∆EDSS), development of disability progression (DP) and annualized relapse rate (ARR) were assessed. Results No significant differences were observed in MS patients, based on their presence of variations in extracranial venous anatomy at baseline or at the follow-up, in ∆EDSS, development of DP or ARR. While more MS patients had ISNVD CCSVI criteria fulfilled at baseline compared to HIs (58% vs. 37%, p = 0.03), no differences were found at the 5-year follow-up (61% vs. 56%, p = 0.486). Discussion This is the longest follow-up study assessing the longitudinal relationship between the presence of variations in extracranial venous anatomy and clinical outcomes in MS patients. Conclusion: The presence of variations in extracranial venous anatomy does not influence clinical outcomes over the 5-year follow-up in MS patients.http://link.springer.com/article/10.1186/s12883-019-1350-2Multiple sclerosisExtracranialVariations in extracranial venous anatomyCCSVIRelapse rateDisability progression |
| spellingShingle | Sirin Gandhi Karen Marr Marcello Mancini Maria Grazia Caprio Dejan Jakimovski Avinash Chandra Jesper Hagemeier David Hojnacki Channa Kolb Bianca Weinstock-Guttman Robert Zivadinov No association between variations in extracranial venous anatomy and clinical outcomes in multiple sclerosis patients over 5 years BMC Neurology Multiple sclerosis Extracranial Variations in extracranial venous anatomy CCSVI Relapse rate Disability progression |
| title | No association between variations in extracranial venous anatomy and clinical outcomes in multiple sclerosis patients over 5 years |
| title_full | No association between variations in extracranial venous anatomy and clinical outcomes in multiple sclerosis patients over 5 years |
| title_fullStr | No association between variations in extracranial venous anatomy and clinical outcomes in multiple sclerosis patients over 5 years |
| title_full_unstemmed | No association between variations in extracranial venous anatomy and clinical outcomes in multiple sclerosis patients over 5 years |
| title_short | No association between variations in extracranial venous anatomy and clinical outcomes in multiple sclerosis patients over 5 years |
| title_sort | no association between variations in extracranial venous anatomy and clinical outcomes in multiple sclerosis patients over 5 years |
| topic | Multiple sclerosis Extracranial Variations in extracranial venous anatomy CCSVI Relapse rate Disability progression |
| url | http://link.springer.com/article/10.1186/s12883-019-1350-2 |
| work_keys_str_mv | AT siringandhi noassociationbetweenvariationsinextracranialvenousanatomyandclinicaloutcomesinmultiplesclerosispatientsover5years AT karenmarr noassociationbetweenvariationsinextracranialvenousanatomyandclinicaloutcomesinmultiplesclerosispatientsover5years AT marcellomancini noassociationbetweenvariationsinextracranialvenousanatomyandclinicaloutcomesinmultiplesclerosispatientsover5years AT mariagraziacaprio noassociationbetweenvariationsinextracranialvenousanatomyandclinicaloutcomesinmultiplesclerosispatientsover5years AT dejanjakimovski noassociationbetweenvariationsinextracranialvenousanatomyandclinicaloutcomesinmultiplesclerosispatientsover5years AT avinashchandra noassociationbetweenvariationsinextracranialvenousanatomyandclinicaloutcomesinmultiplesclerosispatientsover5years AT jesperhagemeier noassociationbetweenvariationsinextracranialvenousanatomyandclinicaloutcomesinmultiplesclerosispatientsover5years AT davidhojnacki noassociationbetweenvariationsinextracranialvenousanatomyandclinicaloutcomesinmultiplesclerosispatientsover5years AT channakolb noassociationbetweenvariationsinextracranialvenousanatomyandclinicaloutcomesinmultiplesclerosispatientsover5years AT biancaweinstockguttman noassociationbetweenvariationsinextracranialvenousanatomyandclinicaloutcomesinmultiplesclerosispatientsover5years AT robertzivadinov noassociationbetweenvariationsinextracranialvenousanatomyandclinicaloutcomesinmultiplesclerosispatientsover5years |