Multiple sclerosis (MS) may be caused by abnormal blood flow caused by twisted or clogged veins, claims Paolo Zamboni, a vascular surgeon and professor of medicine at the University of Ferrara (Italy).

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He accepts that the symptoms of MS are due to damaged myelin sheath* but questions the hypotheses that the damage is caused primarily by (e.g.) autoimmune activity, or a virus in childhood, or vitamin D deficiency, or hormonal activity.

Paolo formed his hypothesis after conducting a simple operation to mend twisted and clogged veins in his wife’s neck and upper chest in 1995. She had begun to experience all of the symptoms of MS, and has not had an attack since.

Paolo’s hypothesis
Twisted or clogged veins can both impede the drainage of blood from the brain, and even cause blood that has left the brain to flow back into it. This leads to a build up of iron in the brain, damaging the brain-blood barrier, causing damage to the myelin sheath and disrupting various brain activities. Paolo has termed these effects of twisted and clogged veins ‘chronic cerebrospinal venous insufficiency’ (CCVI).

Evidence for his hypothesis includes:

• Ultrasound scans found that over 90% of people with multiple sclerosis had malformations or blocks in the veins draining blood from the brain. This phenomenon was not found in healthy people
• During the two years after Paolo’s surgery had been carried out (now nicknamed ‘The Liberation Treatment’) the average proportion of active lesions in the brains of 65 patients with the relapsing-remitting form of MS (the most common form) fell sharply, from 50% to 12%. Nearly three quarters of the patients treated had no further attacks at all
• Links between iron deposits and MS are recorded elsewhere in medical literature

Progress

The Buffalo Neuroimaging Analysis Center (US) is currently recruiting 1,700 adults and children from the United States and Canada on whom to do detailed analyses of (i) blood flow in and out of the brain and (ii) related iron deposits

• Adjunct professor at McMaster University in Hamilton (US) Mark Haacke is also measuring iron build-up in the brain
• The Kuwaiti Department of Health is so impressed with these early results that it has authorised its surgeons to treat CCVI with Paolo’s methods within the country’s state-financed health service

* Myelin is a collection of lipid fats and proteins that sheaths the long transmitting extensions of nerve cells (neurons) called axons. Nerve signals pulse down a properly sheathed axon at anything from five to thirty metres per second. Demyelinating an axon can reduce pulsing to between half and two metres per second.