Easing Blood Flow in Neck Reduces Headaches, Fatigue in Certain MS Patients, Study Shows

Easing Blood Flow in Neck Reduces Headaches, Fatigue in Certain MS Patients, Study Shows

Removing obstructions in large neck veins reduced multiple sclerosis patients’ headaches for several years, British and Italian researchers have demonstrated.

The magnitude and duration of the effect differed among patients with different types of MS, however.

Researchers also found that the treatment reduced fatigue, particularly in relapsing-remitting (RR) MS patients. But fatigue reductions waned much quicker than headache reductions, and were not as robust, the study in the journal PLOS ONE showed.

This prompted the team to suggest that the method used to remove neck vein obstructions — balloon angioplasty — may be useful for treating persistent headaches in MS patients with obstructed veins. The researchers were from Leeds Beckett University in the U.K. and the Catania University Hospital in Italy.

It was only about 10 years ago that researchers suggested that many MS patients have obstructed blood flow from the brain. The condition, called chronic cerebrospinal venous insufficiency, can be treated by inserting a catheter into the veins, draining the brain and spinal cord. The catheter carries a balloon, which is inflated to open up the blocked blood vessels.

The method is called balloon angioplasty. Despite its common use, it is considered controversial, researchers said — partly because studies are not in agreement about its benefits.

To examine whether the treatment could affect headaches and fatigue in MS patients, researchers recruited 286 MS patients with large neck vein obstruction. They titled their study “Mid-term sustained relief from headaches after balloon angioplasty of the internal jugular veins in patients with multiple sclerosis.”

The study group was composed of 175 RRMS patients, 75 secondary progressive MS (SPMS) patients, and 36 primary progressive MS (PPMS) patients. Among them, 113 had headaches and 277 experienced fatigue. The two groups were not mutually exclusive, as some patients had both headaches and fatigue.

The team measured improvement using the Migraine Disability Assessment tool and the Fatigue Severity Scale, before, and on two occasions after, balloon angioplasty.

Researchers also checked if the blood vessels — the internal jugular veins — were still open at one, six, and 12 months after the procedure and yearly thereafter.

The treatment reduced headaches and fatigue at three months in all the patients. But the result was  not statistically significant for headaches in PPMS patients, likely because of the small number in the group. Reductions in the number of headaches were similar in SPMS and PPMS patients. The most reductions occurred in RRMS patients.

Headache reductions held in RRMS patients over the long term. But at an average follow-up of roughly 3 1/2 years, the number was slightly higher than recorded earlier.

A similar situation was seen in SPMS and PPMS patients, but again the result was not significant in PPMS.

Meanwhile, only RRMS patients’ fatigue continued to be lower at long-term follow-up, although it had increased from the early follow-up. In SPMS and PPMS patients, fatigue scores were lower than initial levels, but the difference was not significant.

Researchers linked improvements in headaches and fatigue with changes in blood flow in the internal jugular veins.

The data suggested that balloon angioplasty may be a valuable way to reduce headaches, and possibly also fatigue, in MS patients with obstructed neck veins, researchers concluded.

Patrícia holds her PhD in Medical Microbiology and Infectious Diseases from the Leiden University Medical Center in Leiden, The Netherlands. She has studied Applied Biology at Universidade do Minho and was a postdoctoral research fellow at Instituto de Medicina Molecular in Lisbon, Portugal. Her work has been focused on molecular genetic traits of infectious agents such as viruses and parasites.
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Patrícia holds her PhD in Medical Microbiology and Infectious Diseases from the Leiden University Medical Center in Leiden, The Netherlands. She has studied Applied Biology at Universidade do Minho and was a postdoctoral research fellow at Instituto de Medicina Molecular in Lisbon, Portugal. Her work has been focused on molecular genetic traits of infectious agents such as viruses and parasites.
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6 comments

  1. Linda La Rowe says:

    Blood flow in the brain can be visualized with MRI. The restricted blood flow in the brain of people with MS is definitely evidenced. Thank you Dr. Zamboni et al for acknowledging this. In addition to blood flow, there is also evidence of blocked CSF flow through the cervical spine. Thanks to Dr. Raymond Damadian, original inventor of the MRI, CSF can be visualized with his advanced hardware and software in the “UPRIGHT” multi positional MRI. When the CSF flow is unblocked, it also opens the restricted blood flow. A book has been written explaining the intricate details of this science and research, The Craniocervical Syndrome and MRI”. I know because I joined an MS study with Dr. Damadian and Dr. Scott Rosa in 2012. I had MS for 29 years and was at the stage of SPMS for 9 of those years at the time. My cervical spine displayed scoliosis with 4 blockage points in my CSF flow. My C1 (atlas disc) was diagonal and the C2was rotated 18 degrees. When CSF flow is blocked, it backs up in the ventricles in the brain, causing it to leak. When you followed the leakage, it went right to the lesions in my brain. Dr. Rosa non invasively performed an image guided cervical alignment using an Atlas Orthogonal instrument and MRI images. My blood flow was also restricted prior to this alignment. Blood flow and CSF flow returned once I was perfectly aligned. The result was that I immediately got my eyesight back (gone for about 3 1/2 years), in two weeks I got the feeling back in my fingers (gone for a dozen years), the feeling back in my abdomen (gone for more than a dozen years), the ability to form a whistle (gone for 25 years), the last two took about a year to get back. None of the regained abilities have regressed and it has been 6 years since I joined this study. I no longer get bladder infections, can drive again and certainly have realized major improvements, especially notable because I was SPMS when I joined this study. I would so love to see the combining of research between Dr. Zamboni and Dr. Damadian as this all seems to be related…and could add another dimension to both schools of research.

  2. Lori Batchelor says:

    I went from having almost weekly “MS headaches” to NONE following venous angioplasty for CCSVI. March 17, 2018 marks my 7-year “angioversary” and 7 years of being headache-free! Many other improvements too, but, Canada still won’t let people with MS have this safe, simple treatment. Our quality of life doesn’t matter.

  3. Becky Johnson says:

    This is really compelling data! I have these MS headaches at least 3 to 4 times monthly and they last 2 to 3 days! It would definitely improve my quality of life to have these gone! Thanks for posting this article!

  4. Carrie G says:

    Can someone tell me where I can get this procesure done? I live in south carolina. Will insurance typically cover it? (I have a BCBS Marketplace plan). How do I convince my neuro to send me to a veinous specialist? Thank you! [email protected]

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