Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Friday, August 16, 2013

Research and Results

"We went in open minded. When we set up the study, we didn't know what to expect. I guess what we anticipated, like most clinical studies, was that there would be some sort of middle ground... [But] this is black and white."
Dr. Ian Rodger, Researcher, McMaster University, Ontario
Before they embarked on their study researchers from McMaster University were in fact enthusiastic of the possibilities inherent in the controversial new theory of the cause of multiple sclerosis and its unique, proposed new treatment. "Liberation" therapy might very well represent a life-affirming formula that would rescue people from desperate lives of deteriorating health leading to early death.

Now, research results in, their message is quite a bit more subdued. Next to no sign in either MS patients or healthy individuals of the narrowing of neck veins that resulted purportedly in blood backups on the brain. Dr. Paolo Zamboni's theory of inflammation causative and triggering of Multiple Sclerosis set at rest as an illusion, nothing more.

Had the theory been proven otherwise there would have been huge celebration. There are greater numbers of people stricken with MS in Canada than any other place in the world. Why this is so has not been explained; another one of life's many mysteries. Perhaps if there was an explanation there might also result some feasible treatment, if not an outright cure. But perhaps is an uncertain word, a wistful one.

Dr. Rodger, now spokesman as lead researcher of the McMaster team had been convinced at the start of the study that resistance to the purportedly positive findings that emerged with the initial reports of "Liberation" therapy represented the typical reaction of the medical establishment. Which historically balks at any therapy or finding that deviates from the tried and true, the expected. Establishment resists the novel.

Now he's part of the "establishment" culture once again. It is his hypothesis, and a fairly reasonable one that the reason previous research found evidence of constricted blood vessels was due to the simple enough expedient of ultrasound operators pressing too hard on the necks of patients, thus physically causing veins to narrow and appear blocked. Sometimes the obvious is simply unnoticed.

The original news of the new experimental treatment and its perceived successes through personal narratives caused thousands of people to desperately seek relief from their dire medical condition. Governments and health charities expended millions to test the theory. A Canadian federally funded trial of the treatment undertaken in response to intense pressure from patients is still in early stages.

Nothing is absolute, however, until it is absolutely proven and without a doubt accepted as final. The MS patients anxious to take advantage of a final cure or at the very least living aid to control the progression of their disease, came up against the opinion of their neurologists who dismissed the concept as risky and unproven. In actual fact there have bee a number of deaths attributable to the procedure.

The experts remain convinced that MS results from an auto-immune reaction, like Type 1 diabetes. The McMaster study claims to have discovered zero evidence of the vein narrowing, called chronic cerebrospinal venus insufficiency (CCSVI). It adds to a body of research calling the Zamboni theories into question.

And predictably, president of the CCSVI Society of Canada claims the McMaster study results should be viewed as suspect, standing alone as the only one up to now to find no evidence whatever of the blockages. "Their methodology is obviously not on the target. When studies can't find what is routinely being found in other studies, they [usually] don't even publish", said Sandra Birrell.

Before embarking on their research project the McMaster researchers dispatched two ultrasound operators and a radiologist to Italy to train in the Zamboni lab. Specifically for the purpose of avoiding accusations they were missing the problem due to faulty techniques. Only one of the 200 subjects -- an MS patient it turns out -- demonstrated any sign of the vein "stenosis", the narrowing that Dr. Zamboni had identified in every patient he had himself examined.

Earlier this year an Italian study was published wherein the Zamboni ultrasound techniques revealed that about a third of both MS patients and healthy subjects alike that were tested had CCSVI.

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