1. Observational case-control study of the prevalence of chronic cerebrospinal venous insufficiency in multiple sclerosis: results from the CoSMo study
- Author
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G. Comi, M. Battaglia, A. Bertolotto, M. D. Sette, A. Ghezzi, G. Malferrari, M. Salvetti, M. Sormani, L. Tesio, E. Stolz, P. Zaratin, G. Mancardi, A. CoSMo Collaborative Study group [, A. Protti, A. Ciuffoli, A. Bratina, A. Guccione, A. Deboni, B. Giometto, C. Finocchi, C. Baracchini, D. Maimone, D. Rossato, D. Centonze, D. Ciampanelli, E. Favaretto, E. Menci, E. Granieri, E. Sanzaro, F. Viaro, F. Bortolon, F. Iemolo, F. Patti, F. Tezzon, G. Costantino, G. L. Mancardi, G. Sette, G. M. Nuzzaco, L. Provinciali, L. Coppo, L. D. Maggio, L. Monti, L. Pascazio, L. Grimaldi, L. Motti, M. Mancini, M. Busso, M. Rovaris, M. Buccafusca, M. L. Zedde, M. R. Tola, M. Trojano, M. Spinelli, M. Stefanini, M. Cirrito, M. Ulivelli, N. Carraro, N. D. Rossi, P. Cavalla, P. Gallo, P. Lochner, P. Cecconi, R. Mantegazza, R. Gaeta, R. Bergamaschi, R. Capra, S. Cottone, S. Sanguigni, S. Stecchi, S. Grazioli, S. Tonello, V. B. Morra], LUGARESI, ALESSANDRA, Comi, G, Battaglia, Ma, Bertolotto, A, Del Sette, M, Ghezzi, A, Malferrari, G, Salvetti, M, Sormani, Mp, Tesio, L, Stolz, E, Zaratin, P, Mancardi, G, BRESCIA MORRA, Vincenzo, CoSMo COllaborative Study, Group, Giometto, B, G. Comi, M. Battaglia, A. Bertolotto, M. D. Sette, A. Ghezzi, G. Malferrari, M. Salvetti, M. Sormani, L. Tesio, E. Stolz, P. Zaratin, G. Mancardi, A. CoSMo Collaborative Study group [, Alessandra Lugaresi, A. Protti, A. Ciuffoli, A. Bratina, A. Guccione, A. Deboni, B. Giometto, C. Finocchi, C. Baracchini, D. Maimone, D. Rossato, D. Centonze, D. Ciampanelli, E. Favaretto, E. Menci, E. Granieri, E. Sanzaro, F. Viaro, F. Bortolon, F. Iemolo, F. Patti, F. Tezzon, G. Costantino, G. L. Mancardi, G. Sette, G. M. Nuzzaco, L. Provinciali, L. Coppo, L. D. Maggio, L. Monti, L. Pascazio, L. Grimaldi, L. Motti, M. Mancini, M. Busso, M. Rovari, M. Buccafusca, M. L. Zedde, M. R. Tola, M. Trojano, M. Spinelli, M. Stefanini, M. Cirrito, M. Ulivelli, N. Carraro, N. D. Rossi, P. Cavalla, P. Gallo, P. Lochner, P. Cecconi, R. Mantegazza, R. Gaeta, R. Bergamaschi, R. Capra, S. Cottone, S. Sanguigni, S. Stecchi, S. Grazioli, S. Tonello, V. B. Morra], Comi, Giancarlo, and CoSMo Collaborative Study, Group
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Adult, Brain ,blood supply, Case-Control Studies, Female, Humans, Male, Middle Aged, Multiple Sclerosis ,complications/epidemiology, Prevalence, Spinal Cord ,blood supply, Venous Insufficiency ,complications/epidemiology ,Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Neurology ,Chronic cerebrospinal venous insufficiency ,multicentric study ,multiple sclerosis ,neurodegenerative disease ,Prevalence ,medicine ,Humans ,circulatory system ,sonography ,Chronic cerebrospinal venous insufficiency, Italy, circulatory system, multicentric study, multiple sclerosis, neurodegenerative disease, prevalence study, sonography ,business.industry ,Multiple sclerosis ,prevalence study ,Case-control study ,Brain ,Middle Aged ,medicine.disease ,blood supply ,Surgery ,Spinal Cord ,Venous Insufficiency ,Italy ,Case-Control Studies ,multiple sclerosi ,Duplex sonography ,Female ,Observational study ,Settore MED/26 - Neurologia ,Neurology (clinical) ,business - Abstract
Background: Chronic cerebrospinal venous insufficiency (CCSVI) has been proposed as a possible cause of multiple sclerosis (MS). Objectives: The CoSMo study evaluated the association between CCSVI and MS. Methods: The primary end-point of this multicentric, case-control study was to compare the prevalence of CCSVI between patients with MS, patients with other neurodegenerative diseases (ONDs) and healthy controls (HCs). Color-coded duplex sonography was performed by a sonologist and the images were sent to one of three central sonologists for a second reading. Agreement between local and central sonologists or, in case of disagreement, the predominant judgment among the three central readers, was required for a diagnosis of CCSVI. All readings, data collection and analysis were blinded. Results: The study involved 35 MS centers across Italy and included 1874 subjects aged 18–55. 1767 (94%) were evaluable: 1165 MS patients, 226 patients with ONDs and 376 HCs. CCSVI prevalence was 3.26%, 3.10% and 2.13% for the MS, OND and HC groups, respectively. No significant difference in CCSVI prevalence was found amongst the three cohorts (MS versus HC, OR = 1.55, 95%CI = 0.72–3.36, p = 0.30; OND versus HC, OR = 1.47, 95%CI = 0.53–4.11, p = 0.46; MS versus OND, OR = 1.05, 95%CI = 0.47–2.39, p = 0.99). High negative and low positive agreement was found between the local and centralized readers. Conclusions: CCSVI is not associated with MS.
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- 2013