On the Historical Succession of Vessel-Based Therapies in the Treatment of Multiple Sclerosis

Abstract

Since 2009, the (CCSVI) model of multiple sclerosis has drawn much attention, and the associated surgical ‘venoplasty' interventions have often been advertised as a novel idea. In fact, it is a new incarnation of various vessel-based therapies attempted for multiple sclerosis in the past, dating back to the 1930s, when Tracy Jackson Putnam (1894-1975) attempted pharmacological anticoagulation. This was followed in the 1940s by Richard M. Brickner's (1896-1959) studies of vasodilatory drugs, which further inspired trials of sympathectomy and ganglionectomy. In the 1950s, Ilya Mark Scheinker (1902-1954) studied vasopressor therapy, while Roy Laver Swank (1909-2008) investigated the effects of a low saturated fat diet in his patients. This paper discusses the longer history of these therapeutic endeavours and the aetiological theories that inspired them.

Review of Two Popular Eating Plans within the Multiple Sclerosis Community: Low Saturated Fat and Modified Paleolithic

“…Swank’s studies have been criticized for not being randomized controlled trials; his comparison of ‘good’ and ‘poor’ responders may also be biased towards a positive result because patients who are feeling well are more likely to adhere to the ≤20 g saturated fat restriction while those who are declining may abandon it [63]. His reports were also criticized for not using blinded assessors [64,65]. Additional weaknesses include the risk of missing data that is not missing at random but missing as part of the disease process, selection bias, exclusion of patients who were following the diet ‘poorly,’ absence of brain MRI data and the lack of standardized validated dietary assessment measures.…”

Nutrient Composition Comparison between the Low Saturated Fat Swank Diet for Multiple Sclerosis and Healthy U.S.-Style Eating Pattern

“…He thought this may be the result of the obstruction of small blood vessels due to increased clustering of chylomicrons after consumption of a high fat meal [10,23,24,25,26,27]. Various vessel-based theories of MS have been suggested since 1863 and continue today with the chronic cerebrospinal venous insufficiency theory [28] and hypotheses of cholesterol and disordered lipid metabolism [29,30]. Total cholesterol [31] and low density lipoproteins [32] have been positively associated with disability.…”

Failure of the vascular hypothesis of multiple sclerosis in a rat model of chronic cerebrospinal venous insufficiency

“…The chronic insufficient venous drainage occurring in the course of CCSVI was postulated to cause multiple sclerosis (MS) through the deposition of iron in the walls of the congested veins and in the brain tissue [43]. Multiple sclerosis is a chronic incurable demyelinating disease of the central nervous system, which affects up to 2.5 million people worldwide [15].…”