All research applications underwent a rigorous review by an international review panel that included experts from various disciplines including interventional radiology, vascular surgery and neurology. The MS Society of Canada and the U.S. National MS Society worked collaboratively to assemble the reviewers who considered scientific merit, feasibility of proposed research and the experience of the applicant teams.
“The MS Society of Canada is committed to funding strong science, backed by research goals that move us forward in our pursuit to end MS,” says Yves Savoie, president and CEO of the MS Society of Canada. “I am very pleased that grantees, their collaborators and their host institutions will help us play a part in better understanding CCSVI and its relationship to MS.”
The total amount of funding committed by the MS Society of Canada is $700,000.
These new studies are necessary because we don’t yet know whether, or if so how, CCSVI contributes to MS disease activity. They will achieve several important goals. First, the new studies will carry out significant steps needed to confirm the phenomenon originally described by Dr. Paolo Zamboni who reported abnormalities in the veins draining the brain and spinal cord in people with MS and resolve the questions raised by him and others as to whether CCSVI is a cause of MS or related to MS in some other manner. Second, these studies will resolve conflicting data from previous research. Third, if blockages are found, the findings will speed the way to determining whether therapeutic trials to correct them will be helpful in improving or altering MS disease process.
The new projects take a comprehensive look at the structure and function of the veins draining the brain and spinal cord in people representing a spectrum of MS types, severities and durations, and compare them to structure and function of veins in people with other diseases and healthy volunteers. The studies incorporate accepted high standards of experimental blinding and controls designed to provide unbiased results. They also use a variety of imaging technologies including the Doppler ultrasound technology originally used by Dr. Zamboni and his team.
Together, these studies aim to further understand the possible role of CCSVI in MS and identify optimal methods for screening for the condition, which would be necessary to determine the next steps required in advancing the CCSVI lead. They will also be of value in designing protocols for possible therapeutic trials that might be independently undertaken in North America or overseas.
The international review panel recommended studies they agreed combined the strongest science with the research goals necessary to most quickly determine the scope and meaning of reported abnormalities in blood drainage from the brain and spinal cord in MS. The two-year grants will begin July 1, 2010.
The funded teams, which include an integration of MS, vascular and imaging experts, are led by:
Dr. Brenda Banwell, The Hospital for Sick Children, Toronto, Ontario: studying vein abnormalities in children and teenagers who have MS, and healthy controls of the same age. The team is seeking to determine whether the veins are abnormal at an early age among pediatric MS patients. These findings will add additional depth to studies of CCSVI in adult MS. Fact sheet
Dr. Fiona Costello, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta: examining a cross-section of people with MS compared to other neurological diseases and healthy volunteers. The team is seeking linkages between vein abnormalities and different aspects of MS activity and tissue damage to gain insight into the significance of differences in vein drainage and their implications for the future treatment of MS. Fact sheet
Dr. Aaron Field, University of Wisconsin School of Medicine and Public Health, Madison: using magnetic resonance (MRI) scans to generate detailed images of the head and neck veins in people with early and later MS, healthy volunteers, and controls with other neurological conditions. This team is also using the ultrasound techniques originally used by Dr. Zamboni. If they obtain similar results as those published by Dr. Zamboni, it would represent a powerful confirmation of the CCSVI hypothesis and help lead the way toward trials of appropriate treatment. More information: www.nationalmssociety.org/ccsvi
Dr. Robert Fox Cleveland Clinic, Cleveland: studying people with MS or who are at risk for MS (CIS) and comparison groups including healthy volunteers and people with brain atrophy (shrinkage) from Alzheimer’s disease. This team is using the ultrasound techniques originally used by Dr. Zamboni, as well as magnetic resonance studies of the veins (MR venography), MRI scans of the brain, and clinical measures to determine MS activity and atrophy. They are also examining neck and spinal cord tissue from MS patients at autopsy to provide a tissue-based evaluation of CCSVI and its possible relationship to MS. More information: www.nationalmssociety.org/ccsvi
Dr. Carlos Torres, The Ottawa Hospital, University of Ottawa, Ontario: employing powerful MRI technology to explore vein anatomy and assessing for iron deposits in the brains of people with MS and in age-matched healthy volunteers. These studies work towards mapping out normal variations in brain vein anatomy and providing insight into CCSVI in MS. Fact sheet
Dr. Anthony Traboulsee, UBC Hospital MS Clinic, UBC Faculty of Medicine and Dr. Katherine Knox, Saskatoon MS Clinic, University of Saskatchewan: studying the prevalence of CCSVI in people with MS and controls without MS, using catheter venography, ultrasound, and magnetic resonance venography. Unique to this study is the inclusion of family members, such as identical twins of MS patients who have not developed MS, in control groups. They also hope to verify the usefulness of techniques that would make it easier to screen for CCSVI. Fact sheet
Dr. Jerry Wolinsky, University of Texas Health Science Center at Houston: replicating the ultrasound methods used by Dr. Zamboni to investigate the association of CCSVI with major clinical types of MS and in non-MS control groups. The team is also testing whether other imaging methods can confirm the ultrasound findings, while identifying the most reliable technique to screen for CCSVI. More information: www.nationalmssociety.org/ccsvi
The work of the researchers in these initial studies will not involve surgical treatment, but rather the investigation and determination of CCSVI’s prevalence in different circumstances.
It is expected that the majority of Canadian participants to be recruited will come from existing patient rosters at MS clinics associated with the projects. As a funder, the MS Society of Canada plays no role in selecting people to participate in studies.
As part of the MS Society’s commitment to providing timely information as work on these grants proceeds, researchers will be asked to provide 6-month interim updates to the MS Society on their grant progress. Publication in peer-reviewed journals will occur as results are established.
Mike Augustine, a person with MS from Mississauga, Ontario, is excited about the potential of the funded research. “I feel fortunate to be a part of the strong partnership between people living with MS, researchers and the MS Societies of Canada and the U.S.,” he says. “We are all working toward a common goal and that is to end MS. It’s gratifying to see that we are all on the same side in pursuing leads of great potential.”
The MS Society of Canada administers a number of competitions that are open to Canadian-based researchers every year focused on promising areas of MS research. The next one, slated to open shortly, is targeted at large, multi-centre, collaborative grants.
About multiple sclerosis and the Multiple Sclerosis Society of Canada
Multiple sclerosis is a chronic, often disabling disease of the brain and spinal cord. It is the most common neurological disease of young adults in Canada. Most people with MS are diagnosed between the ages of 15 and 40, and the unpredictable effects of MS last for the rest of their lives. The MS Society provides services to people with MS and their families and funds research to find the cause and cure for this disease.
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