BNAC

CCSVI is one of the most controversial topics in modern medical history. CCSVI is held in particular disdain within the neurologic community. University of Buffalo researchers issued a press release regarding their study of CCSVI on March 15th, which was followed shortly by the annual meeting of the American Academy of Neurology (AAN) on March 16th. The press release stated that treatment of CCSVI had no sustained impact on multiple sclerosis. It should be noted that the press release did not state that the results of the study had been accepted for publication or that the results would be presented at the AAN meeting.

However, the Buffalo team did note that the procedure is safe based on their experience. This is consistent with the three previously published studies also demonstrating the safety of treating CCSVI. Petrov, Ludyga, and Mandato.We all know that invasive procedures have risks, but based on the published evidence and the findings of BNAC’s study, limiting access to this procedure cannot be justified on safety grounds. The BNAC study lacks value because it is based on a misunderstanding of what CCSVI is and its impact on disease. However, it is reassuring to know that the procedure is safe, especially based on a randomized trial. With continued performance of this procedure will come greater knowledge and understanding of its impact on health.

CCSVI has not been defined as a clinical entity. It is not identified as a disease or a clinical condition. It is described as a physiologic state of impaired CNS venous flow. With this definition, clinical identification has rested solely on vascular imaging. Treatment decisions based on pictures not health status of the patient. At present, definitive imaging criteria has yet to be delineated and validated. The relative incidence of this condition in patients with a particular disease, for example MS, cannot be reasonably ascertained.

Autonomic dysfunction is well established as an associated condition of MS. As it is for all neurodegenerative diseases and a host of other disorders. Zohara Sternberg clearly described the interaction of the autonomic dysfunction in MS and how the CCSVI treatment effect may in fact be an autonomic one Sternberg. I presented my findings of approximately 500 Synergy patients all presenting with symptoms of autonomic dysfunction at the 2013 VDF annual meeting. I also presented my findings of HRV analysis objectively demonstrating a response to therapy following treatment of CCSVI at the 2013 CSI-Trends meeting. I previously presented an observed normalization of blood pressure in several hundred patients treated for CCSVI at the 2012 meeting of the American College of Phlebology.

Sternbergs hypothesis that the effect of the CCSVI procedure is autonomic in nature is supported by my findings. It is also my observation that symptomatic response following treatment is not linked to the presence of MS. A diverse array of conditions such as Parkinson’s, Lyme, Fibromyalgia and Chronic Fatigue that are established as having dysautonomia also respond to the procedure. Confirmation of these of these findings by other practitioners and trials of dysautonomia patients, not limited to just MS, may lead to a better understanding of what this is and how it may impact health. Further study of CCSVI and its impact on MS, without assessment of autonomic symptoms, will likely only prolong the controversy.