The value of cerebral Doppler venous haemodynamics in the assessment of multiple sclerosis
Section snippets
Patients and controls
We admitted to the first part of the study 120 patients affected by clinically defined MS (CDMS), diagnosed according to the recommended criteria [22]. We also recruited 200 controls subdivided into three groups: i) 60 healthy subjects homogeneous for age and gender with MS patients (HM-C); ii) 80 healthy subjects older than the median age of the European MS population (HA-C) [23]; and iii) 60 patients affected by other neurological diseases (OND).
Patients and controls
Table 2a, Table 2b show clinical and demographic characteristics for the entire group of MS patients, as well as for the subgroups. Significant differences were found, as expected, in the followings:
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Age: SP vs RR, p < 0.01. PP vs RR, p < 0.01 (ANOVA).
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EDSS: SP vs RR, p < 0.01. PP vs RR, p < 0.01 (ANOVA).
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Disease duration: SP vs RR, p < 0.01 (ANOVA).
Physiologic flow direction in the IJVs and\or VVs with the head in any position
Venous flow direction was consistently directed toward the heart with the head in any position, and increased by inspiration in all controls. Bidirectional flow
Discussion
The principal result of our study is the original description of the overturning of the physiologic regulation of venous return assessed in our CDMS population, with parameters that are significantly different from those of all control groups (Table 3, Fig. 1, Fig. 2, Fig. 3, Fig. 4). The latter include also older subject (Tables 2a) and OND patients (Tables 2b). Had Doppler hemodynamic anomalies been present in the healthy aged control group, we would not have been able to maintain that they
Competing financial interests
None.
Funding
Research supported by the Italian Ministry for University and Scientific Research and by the Foundation Cassa di Risparmio di Ferrara.
Acknowledgments
We wish to thank Mrs Francesca Pancaldi for her help in organising this study and in preparing the manuscript. Many thanks to Roberto Manfredini, MD, Head of the Department of Internal Medicine of the Delta Hospital Lagosanto, Ferrara, Italy, and his staff for the valuable selection of control subjects.
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Center for Rare and Neuroimmunitary Diseases, Bellaria Hospital, Bologna, Italy