Έπεσα κατά τύχη πάνω σε μια προδημοσιεύση ενός άρθρου που έψαχνα καιρό και που στην ουσία περιέχει την κριτική απέναντι στη θεωρία του καθ. Ζαμπόνι:
http://www.konkretia.net/pdf/Neuro_Critique.pdf
Κατά μια έννοια δίνει και ερευνητικές κατευθύνσεις για το πώς θα μπορούσε να αποκλειστεί η ΧΕΝΦΑ ως αίτιο της ΠΣ, κατευθύνσεις που ακολουθήθηκαν σε πρόσφατη μελέτη που παρουσιάστηκε στο ECTRIMS 2010 στο Γκέτεμπουργκ της Σουηδίας:
Chronic cerebrospinal venous insufficiency is an unlikely cause of multiple sclerosis
B. Yamout, A. Herlopian, Z. Issa, R.H. Habib, A. Fawaz, J. Salameh, H. Wadih, H. Awdeh, N. Muallem, R. Raad, A. Al-Kutoubi (Beirut, LB)
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Introduction: A state of chronic cerebrospinal venous insufficiency (CCSVI) secondary to extracranial venous stenosis (EVS) was suggested as a possible cause of multiple sclerosis (MS).
Methods: In this study we performed selective extracranial venous angiography (SV) on 42 patents with early MS (EMS): clinically isolated syndrome (CIS) or relapsing remitting MS (RRMS) of less than 5 years duration, and late MS (LMS): RRMS of more than 10 years duration. We also reviewed available MRI and clinical relapse data in patients with documented EVS.
Results: EVS was present in 7/29 (24%) patients with EMS and 12/13(92%) patients with LMS, a highly significant statistical difference (p<0.0001). Only 3/42 (7%) patients (all in the LMS group) had 2 vessel stenosis, while the rest had only 1 vessel involved. The incidence of EVS in CIS was 9% compared to 33% in RRMS of less than 5 years duration. The most important factor in determining presence of EVS was disease duration: mean=9.4±6.8 years in 19 patients with EVS compared to 3.2±4.1 years in patients without (p<0.005), which stayed significant after controlling for age at disease onset and gender (p<0.002). Within the EMS group, patients with (n=7) and without (n=22) EVS had similar EDSS (1.43±2.13 and 0.8±0.008, p=0.85) and disease duration (mean =2.1 and 2.4 years, p=0.521), suggesting similar disease severity. The 7 EMS patients with stenosis had a total of 14 relapses since disease onset. No clear correlation could be found between site of EVS and relapse anatomical localization. A total of 97 spine and brain MRIs available since disease onset on all 19 patients with stenosis were reviewed. Again no clear correlation could be seen between the location of gadolinium enhancing (Gd+) lesions and site of EVS.
Conclusion: CCSVI is an unlikely cause of MS since it is not present in most cases early in the disease, and in only a minority of MS patients affects more than 1 extracranial vein. It is likely to be a late secondary phenomenon, possibly related to chronic central nervous system (CNS) disease and atrophy.
Φυσικά, ο καθ. Ζαμπόνι δεν είπε ότι η ΧΕΝΦΑ είναι η αιτία της ΠΣ, αλλά τελευταία γίνεται προσπάθεια να παρουσιαστεί η ΧΕΝΦΑ ως κάτι το φυσιολογικό, δηλαδή ως ανατομική διαφοροποίηση που υπάρχει σε πολλούς ανθρώπους.
