Generic placeholder image

Reviews on Recent Clinical Trials


ISSN (Print): 1574-8871
ISSN (Online): 1876-1038


Potential Involvement of Impaired Venous Outflow from the Brain in Neurodegeneration: Lessons Learned from the Research on Chronic Cerebrospinal Venous Insufficiency

Author(s): Marian Simka* and Marcin Skuła

Volume 14, Issue 4, 2019

Page: [235 - 236] Pages: 2

DOI: 10.2174/157488711404191016122006


About 10 years ago, the so-called chronic cerebrospinal venous insufficiency syndrome was discovered. This clinical entity, which is associated with extracranial venous abnormalities that impair venous outflow from the brain, was initially found exclusively in multiple sclerosis patients. Currently, we know that such venous lesions can also be revealed in other neurological pathologies, including Alzheimer’s and Parkinson’s diseases. Although direct causative role of chronic cerebrospinal venous insufficiency in these neurological diseases still remains elusive, in this paper, we suggest that perhaps an abnormal venous drainage of the brain affects functioning of the glymphatic system, which in turn results in the accumulation of pathological proteins in the cerebral tissue (such as β-synuclein, β-amyloid and α-synuclein) and triggers the venous outflow from the cranial cavity and circulation of the cerebrospinal fluid in the settings of neurodegenerative disease.

Keywords: Alzheimer disease, balloon angioplasty, chronic cerebrospinal venous insufficiency, jugular vein, multiple sclerosis, neurodegeneration, Parkinson disease.

Zamboni P, Galeotti R, Menegatti E, et al. Chronic cerebrospinal venous insufficiency in patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 2009; 80: 392-9.
Zamboni P, Galeotti R, Menegatti E, et al. Endovascular treatment of chronic cerebrospinal venous insufficiency, A prospective open-label study. J Vasc Surg 2009; 50: 1348-58.
Siddiqui AH, Zivadinov R, Benedict RH, et al. Prospective randomized trial of venous angioplasty in MS (PREMiSe). Neurology 2014; 83: 441-9.
Traboulsee A, Machan L, Girard M, et al. Venoplasty of chronic cerebral spinal venous insufficiency to improve MS patient reported outcomes is not superior to sham treatment at week 2 or week 12. J Neurol Sci 2017; 381(Suppl.): 1066.
Zamboni P, Tesio L, Galimberti S, et al. Efficacy and safety of extracranial vein angioplasty in multiple sclerosis. JAMA Neurol 2018; 75: 35-43.
Juurlink BH, Bavera PM, Sclafani S, et al. Brave Dreams: An overestimated study, crippled by recruitment failure and misleading conclusions. Veins Lymphatics 2018; 7: 7340.
Simka M. Chronic cerebrospinal venous insufficiency theory after the Brave Dreams study. Phlebol Rev 2018; 26: 1-3.
Giaquinta A, Beggs CB, Veroux M, et al. Factors influencing the hemodynamic response to balloon angioplasty in the treatment of outflow anomalies of internal jugular veins. J Vasc Surg Venous Lymphat Disord 2017; 5: 777-88.
Kazibudzki M, Latacz P, Ludyga T, et al. Efficacy and safety of cutting balloons for the treatment of obstructive lesions in the internal jugular veins. J Cardiovasc Surg 2016; 57(4): 514-8.
Simka M, Ludyga T, Latacz P, et al. Chronic cerebrospinal venous insufficiency is unlikely to be a direct trigger of multiple sclerosis. Mult Scler Rel Disord 2013; 2: 334-9.
Plog BA, Nedergaard M. The glymphatic system in the CNS health and disease: Past, present and future. Annu Rev Pathol 2018; 13: 379-94.
Simka M. What is the relationship between chronic cerebrospinal venous insufficiency and multiple sclerosis? Rev Vasc Med 2013; 1: 66-70.
Zivadinov R, Chung CP. Potential involvement of the extracranial venous system in central nervous system disorders and aging. BMC Med 2013; 11: 260.
Lodygin D, Hermann M, Schweingruber N, et al. β-Synuclein-reactive T cells induce autoimmune CNS grey matter degeneration. Nature 2019; 566(7745): 503-8.
Beggs CB, Magnano C, Belov P, et al. Internal jugular vein cross-sectional area and cerebrospinal fluid pulsatility in the aqueduct of Sylvius: A comparative study between healthy subjects and multiple sclerosis patients. PLoS One 2016; 11e0153960

© 2023 Bentham Science Publishers | Privacy Policy