Risk factors for chronic cerebrospinal venous insufficiency (CCSVI) in a large cohort of volunteers

• Published in: PloS one 2011-11, Vol.6 (11), p.e28062-e28062
• Main Authors: Dolic, Kresimir, Weinstock-Guttman, Bianca, Marr, Karen, Valnarov, Vesela, Carl, Ellen, Hagemeier, Jesper, Brooks, Christina, Kilanowski, Colleen, Hojnacki, David, Ramanathan, Murali, Zivadinov, Robert
• Format: Article
• Language: English
• Subjects: Adult; Aging; Atherosclerosis; Biology; Cardiovascular system; Central nervous system; Cerebrum - blood supply; Cerebrum - pathology; Chronic Disease; Chronic obstructive pulmonary disease; Cohort Studies; Congenital diseases; Coronary artery disease; Criteria; Demography; Diagnosis; Diet; Dietary supplements; Endothelium; Environmental factors; Epidemiology; Family medical history; Female; Ginkgo biloba; Health risk assessment; Health risks; Health screening; Heart; Heart diseases; Hemodynamics; Homocysteine; Human Experimentation; Humans; Hypertension; Hypoxia; Infectious diseases; Infectious mononucleosis; Intestine; Irritable bowel syndrome; Logistic Models; Male; Medical imaging; Medical research; Medicine; Middle Aged; Mononucleosis; Multiple sclerosis; Nervous system; Nervous system diseases; Neurological diseases; Neurology; Neutrophils; New York - epidemiology; Pathogenesis; Pathology; Physiology; Prevalence; Questionnaires; Regression analysis; Risk analysis; Risk Factors; Skull; Smoking; Spinal Cord - blood supply; Spinal Cord - pathology; Studies; Thromboembolism; Thrombosis; Ultrasonography, Doppler; Veins & arteries; Venous insufficiency; Venous Insufficiency - diagnosis; Venous Insufficiency - diagnostic imaging; Venous Insufficiency - epidemiology; Venous Insufficiency - physiopathology; Volunteers
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0028062

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. Nor have risk factors been determined for increased susceptibility of venous pathology in the intra-cranial and extra-cranial veins. The aim of this study was 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 known central nervous system pathology. 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 then 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. 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. Risk factors for CCSVI differ from established risk factors for peripheral venous diseases. Vascular, infectious and inflammatory factors were associated with higher CCSVI frequency.