Alternative Multiple Sclerosis Treatment

[Guest guest]

Researcher's labour of love leads to MS breakthrough

 

Elena Ravalli was a seemingly healthy 37-year-old when she began to

experience strange attacks of vertigo, numbness, temporary vision loss and

crushing fatigue. They were classic signs of multiple sclerosis, a potentially

debilitating neurological disease.

 

It was 1995 and her husband, Paolo Zamboni, a professor of medicine at the

University of Ferrara in Italy, set out to help. He was determined to solve the

mystery of MS †" an illness that strikes people in the prime of their lives but

whose causes are unknown and whose effective treatments are few.

 

What he learned in his medical detective work, scouring dusty old books and

using ultra-modern imaging techniques, could well turn what we know about MS on

its head: Dr. Zamboni's research suggests that MS is not, as widely believed, an

autoimmune condition, but a vascular disease.

 

More radical still, the experimental surgery he performed on his wife offers

hope that MS, which afflicts 2.5 million people worldwide, can be cured and even

largely prevented.

 

“I am confident that this could be a revolution for the research and

diagnosis of multiple sclerosis,†Dr. Zamboni said in an interview.

 

Not everyone is so bullish: Skeptics warn the evidence is too scant and

speculative to start rewriting medical textbooks. Even those intrigued by the

theory caution that MS sufferers should not rush off to get the surgery †"

nicknamed the “liberation procedure††" until more research is done.

 

U.S. and Canadian researchers are trying to test Dr. Zamboni's premise.

 

For the Italian professor, however, the quest was both personal and

professional and the results were stunning.

 

Fighting for his wife's health, Dr. Zamboni looked for answers in the

medical literature. He found repeated references, dating back a century, to

excess iron as a possible cause of MS. The heavy metal can cause inflammation

and cell death, hallmarks of the disease. The vascular surgeon was intrigued †"

coincidentally, he had been researching how iron buildup damages blood vessels

in the legs, and wondered if there could be a similar problem in the blood

vessels of the brain.

 

Using ultrasound to examine the vessels leading in and out of the brain, Dr.

Zamboni made a startling find: In more than 90 per cent of people with multiple

sclerosis, including his spouse, the veins draining blood from the brain were

malformed or blocked. In people without MS, they were not.

 

He hypothesized that iron was damaging the blood vessels and allowing the

heavy metal, along with other unwelcome cells, to cross the crucial brain-blood

barrier. (The barrier keeps blood and cerebrospinal fluid separate. In MS,

immune cells cross the blood-brain barrier, where they destroy myelin, a crucial

sheathing on nerves.)

 

More striking still was that, when Dr. Zamboni performed a simple operation

to unclog veins and get blood flowing normally again, many of the symptoms of MS

disappeared. The procedure is similar to angioplasty, in which a catheter is

threaded into the groin and up into the arteries, where a balloon is inflated to

clear the blockages. His wife, who had the surgery three years ago, has not had

an attack since.

 

The researcher's theory is simple: that the underlying cause of MS is a

condition he has dubbed “chronic cerebrospinal venous insufficiency.†If you

tackle CCSVI by repairing the drainage problems from the brain, you can

successfully treat, or better still prevent, the disease.

 

“If this is proven correct, it will be a very, very big discovery because

we'll completely change the way we think about MS, and how we'll treat it,â€

said Bianca Weinstock-Guttman, an associate professor of neurology at the State

University of New York at Buffalo.

 

The initial studies done in Italy were small but the outcomes were dramatic.

In a group of 65 patients with relapsing-remitting MS (the most common form) who

underwent surgery, the number of active lesions in the brain fell sharply, to 12

per cent from 50 per cent; in the two years after surgery, 73 per cent of

patients had no symptoms.

 

“ I am confident that this could be a revolution for the research and

diagnosis of multiple sclerosis â€â€ " Dr. Paolo Zamboni

 

Augusto Zeppi, a 40-year-old resident of the northern Italian city of

Ferrara, was one of those patients. Diagnosed with MS nine years ago, he

suffered severe attacks every four months that lasted weeks at a time †"

leaving him unable to use his arms and legs and with debilitating fatigue.

“Everything I was dreaming for my future adult life, it was game over,†he

said.

 

Scans showed that his two jugular veins were blocked, 60 and 80 per cent

respectively. In 2007, he was one of the first to undergo the experimental

surgery to unblock the veins. He had a second operation a year later, when one

of his jugular veins was blocked anew.

 

After the procedures, Mr. Zeppi said he was reborn. “I don't remember what

it's like to have MS,†he said. “It gave me a second life.â€

 

Buffalo researchers are now recruiting 1,700 adults and children from the

United States and Canada. They plan to test MS sufferers and non-sufferers alike

and, using ultrasound and magnetic resonance imaging, do detailed analyses of

blood flow in and out of the brain and examine iron deposits.

 

Another researcher, Mark Haacke, an adjunct professor at McMaster University

in Hamilton, is urging patients to send him MRI scans of their heads and necks

so he can probe the Zamboni theory further. Dr. Haacke is a world-renowned

expert in imaging who has developed a method of measuring iron buildup in the

brain.

 

“Patients need to speak up and say they want something like this

investigated … to see if there's credence to the theory,†he said.

 

MS societies in Canada and the United States, however, have reacted far more

cautiously to Dr. Zamboni's conclusion. “Many questions remain about how and

when this phenomenon might play a role in nervous system damage seen in MS, and

at the present time there is insufficient evidence to suggest that this

phenomenon is the cause of MS,†said the Multiple Sclerosis Society of Canada.

 

The U.S. society goes further, discouraging patients from getting tested or

seeking surgical treatment. Rather, it continues to promote drug treatments used

to alleviate symptoms, which include corticosteroids, chemotherapy agents and

pain medication.

 

Many people with multiple sclerosis, though, are impatient for results.

Chatter about CCSVI is frequent in online MS support groups, and patients are

scrambling to be part of the research, particularly when they hear the

testimonials.

 

Kevin Lipp, a 49-year-old resident of Buffalo, was diagnosed with MS a

decade ago and has suffered increasingly severe attacks, especially in the heat.

(Heat sensitivity is a common symptom of MS.) His symptoms were so bad that he

was unable to work and closed his ice-cream shop.

 

Mr. Lipp was tested and doctors discovered blockages in both his jugular and

azygos veins. In January of this year, he travelled to Italy for surgery, which

cleared five blockages, and he began to feel better almost immediately.

 

“I felt good. I felt totally normal. I felt like I did years ago,†he

said. He has not had an attack since.

 

As part of the research project, Mr. Lipp's siblings have also been tested.

His two sisters, both of whom have MS, have significant blockages and iron

deposits, while his brother, who does not have MS, has neither iron buildup nor

blocked arteries.

 

While it has long been known that there is a genetic component to multiple

sclerosis, the new theory is that it is CCSVI that is hereditary †" that people

are born with malformed valves and strictures in the large veins of the neck and

brain. These problems lead to poor blood drainage and even reversal of blood

flow direction that can cause inflammation, iron buildup and the brain lesions

characteristic of multiple sclerosis.

 

It is well-established that the symptoms of MS are caused by a breakdown of

myelin, a fatty substance that coats nerve cells and plays a crucial role in

transmitting messages to the central nervous system. When those messages are

blurred, nerves malfunction, causing all manner of woes, including blurred

eyesight, loss of sensation in the limbs and even paralysis.

 

However, it is unclear what triggers the breakdown of myelin. There are

various theories, including exposure to a virus in childhood, vitamin D

deficiency, hormones †" and now, buildup of iron in the brain because of poor

blood flow.

 

While he is convinced of the significance of his discovery, Dr. Zamboni

recognizes that medicine is slow to accept new theories and even slower to act

on them. Regardless, he can take satisfaction in knowing that the woman who

inspired the quest, and perhaps a dramatic breakthrough, has benefited

tremendously.

 

Dr. Zamboni's wife, Elena, has undergone a battery of scans and neurological

tests and her multiple sclerosis is, for all intents and purposes, gone.

 

“This is probably the best prize of the research,†he said.

 

André Picard is the public health reporter at The Globe and Mail. Avis

Favaro is the medical correspondent at CTV News.

 

With reports from Elizabeth St. Philip, CTV News