What is Multiple Sclerosis?
Multiple sclerosis (MS) is a medical condition wherein the nerves of the brain and the spinal cord are affected and the person experiences difficulty with the movement of muscles, balance and vision.
The nerve fibers in our body have a protective layer of protein known as myelin around them. Myelin contributes in the transmission of electrical signals from the brain to the different parts of our body. In multiple sclerosis, the myelin present around the nerve fibers gets damaged and this effects the transmission of nerve impulses to the different parts of the body.
People suffering from MS exhibit a loss of vision, often in only one eye. The muscles tend to become stiff and this leads to uncontrolled muscle movements. An increased difficulty in balancing and coordination and a feeling of fatigue throughout the day are other common symptoms of multiple sclerosis.
Multiple sclerosis is inflicted by the body’s own immune system and therefore this condition is often described as an autoimmune disease.
Almost 2.1 million people suffer from MS worldwide. Multiple sclerosis is more common in females than in males and a person has the highest risk of developing the disease between teen years to the age of fifty. MS is more common in white people than Asians and black people.
There are several types of MS. The major categories of multiple sclerosis vary depending on the severity of the symptoms and the treatment. The major categories of multiple sclerosis include primary progressive multiple sclerosis, relapsing-remitting multiple sclerosis, secondary progressive multiple sclerosis, and progressive relapsing multiple sclerosis.
Treatment of Multiple Sclerosis
There is no specific cure for MS, but there are numerous treatments that can help in alleviating the symptoms of the disease. The symptoms of relapsing-remitting multiple sclerosis and secondary progressive multiple sclerosis can be treated by using numerous disease modifying drugs which can slow the normal progression of the symptoms and also reduce the chances of relapse of these symptoms.
Common treatments include the use of steroid injections and physiotherapy. Some of the commonly prescribed drugs used for alleviating the symptoms of MS include teriflumonide, glatiramer acetate, interferon beta 1a and b, fingolimod, and mitoxantrone. Most of these drugs act by suppressing or altering the actions of the immune system of the body. None of these drugs cure MS but they can only contribute towards reducing the severity and frequency of the symptoms of the disease.
Surgery For Multiple Sclerosis
There is no cure that is known for multiple sclerosis till date. Most treatments are known to slow the overall progression of the symptoms of the disease. More and more desperate patients are therefore turning to a surgical treatment of multiple sclerosis, proposed by Paolo Zamboni, a vascular surgeon from the University of Ferrara in Italy.
The surgical treatment has been widely criticized by experts in the field of Multiple Sclerosis. It has always been believed that MS is caused when the body’s immune system becomes self-destructive and attacks the layer of myelin present around the nerve fibers. However, Paolo Zamboni does not believe that MS is an autoimmune disease.
Chronic cerebrospinal venous insufficiency is caused by the narrowing down of certain specific veins in the neck and chest. This impedes the flow of blood and results in the accumulation of blood in the brain thereby causing an excess of iron buildup which damages myelin, the protein layer around the nerve fibers.
For treating this condition, Paolo Zamboni advocates the use of stents for opening up the veins that are responsible for carrying blood from the brain. The use of stents normalizes the flow of blood to the brain and eases the buildup of iron which, he believes, damages the myelin layer around the nerve fibers.
Zamboni performed his study on 65 patients suffering from MS, and he found CCSVI to be present in all of them. There were several controversies regarding this study as it was found that his hypothesis was biased. His study was not blinded to the placebo and treated groups and he knew exactly which patients had MS. Since the time this theory was publicized, thousands of MS patients flocked to the nearest clinics to opt for a neck venoplasty, also commonly referred to as the liberation therapy. The response and interest in Zamboni’s study has been so intense that the US National MS society has designated $2.4 million for studies to understand the correlation between CCSVI and MS.
Correlation between CCSVI and MS
Numerous studies have been undertaken post the claims made by Paolo Zamboni attributing CCSVI as a potential factor responsible for causing MS. Most of these studies have failed to find a correlation between CCSVI and MS. The largest study conducted about CCSVI till date was presented at the Congress of the European Committee for Treatment and Research in Multiple Sclerosis at Lyon, France. About 1202 people with MS were part of the study. This group was compared with 669 people who were either healthy or were suffering from some other neurological disorder. The study found that the prevalence of CCSVI was the same in all the three groups and CCSVI could therefore not be attributed as a causal factor for MS.
Another study (Prospective Randomized Endovascular Therapy in MS) was funded by the University of Buffalo and it found that endovascular angioplasty has no effect on MS patients. The U.S Department of Health and Human Services too states that there is no clear evidence that CCSVI is linked to MS and that opting for the liberation therapy does not has a positive impact on the symptoms of MS.
The FDA released a statement in May 2012 warning people about the risks associated with the liberation therapy for treating MS. Common risks associated with endovascular surgery include movement of the stent, damage to blood vessels leading to formation of clots, infection, and bleeding from blood thinners that are prescribed post surgery.