European studies cast doubt on controversial MS treatment

Just days after the Saskatchewan government said it would pony up funding to scientifically verify a controversial treatment for multiple sclerosis, studies in Europe are pouring cold water on so-called "liberation therapy."

The controversial therapy is based on work by Italian neurologist Dr. Paolo Zamboni, who argues that a narrowing or blockage of veins in the neck which drain blood from the brain – a medical condition known as CCSVI or chronic cerebrospinal venous insufficiency – may cause MS symptoms in some cases.

Zamboni contends a procedure similar to balloon angioplasty that unblocks coronary and other arteries – called PTA, or percutaneous transluminal angioplasty – widens these narrowed or blocked veins, improving blood flow and, with it, balance and walking, while reducing dizziness, fatigue, muscle spasms and incontinence.

His initial study found that 73 per cent of patients who underwent the procedure reported a decrease in MS-associated symptoms.

But on Monday, German and Swedish research published in the journal Annals of Neurology finds little connection between narrow blood vessels and MS.

The German study looked at 56 MS patients and 20 others as controls. "Except for one patient, blood flow direction . . . was normal in all subjects," said an abstract of the study published online.

"Our results challenge the hypothesis that cerebral venous congestion plays a significant role in the pathogenesis of MS. Future studies should elucidate the difference between patients and healthy subjects," it added.

The result comes as no surprise to Dr. David Spence, director of the Stroke Prevention and Atherosclerosis Research Centre at the Robarts Research Institute in London, Ont.

"It’s what I think would be expected," he said.

"The evidence we’re getting now is that they’re present in only a small percentage of cases. Only one of the German patients had venous obstructions, and in the Swedish study they didn’t find any. And that’s the problem with the clinical trials – if they can’t find the venous lesions, they can’t put the stents in."

Spence and others are cautioning MS patients not to rush off to such places as India, Poland and Bulgaria for the treatment, which can costs tens of thousands of dollars.

Nevertheless, websites on MS are abuzz with postings by people who have had the surgery and glowingly report that their health has significantly improved.

"Unfortunately, patients with MS and their families, who are so anxious about this, are being victimized by people who are more than willing to take their money," said Spence.

There has been no comment from the Saskatchewan government on the European studies.