Researchers in Hamilton plan to begin patient trials evaluating the work of an Italian scientist whose intriguing treatment for multiple sclerosis has sparked both hope and controversy.
The team of doctors from McMaster University, St. Joseph's Healthcare and Hamilton Health Sciences will test the theory that multiple sclerosis is a vascular disease that can be treated with a simple surgical procedure, angioplasty, to clear blockages in veins. Using magnetic resonance imaging and ultrasound technology, researchers will study veins in the brains of 200 long-suffering patients and healthy people to see if there is a difference between them.
Those results could add to Paolo Zamboni's early findings that multiple sclerosis may be caused by vein blockages that lead to a buildup of iron in the brain - a radical departure from current thinking that MS is an autoimmune condition in which the immune system attacks myelin, a fatty substance that coats nerve cells.
Many in the medical community have been skeptical of Dr. Zamboni's work, because it is preliminary, with a small sample size, and has been heavily promoted before it has gone through the rigorous scientific research process.
On Monday, Dr. Zamboni, in Hamilton for a scientific workshop, came out swinging at his critics. He said he has never proposed that blockages are the only cause of multiple sclerosis, and he welcomed more rigorous testing of his work.
"If I should be a neurologist and read the reports … the first thing that I should do is to investigate the neck veins in my patients, not to criticize the number of patients, the need for further study …," he told reporters.
Dr. Zamboni, a professor of medicine at the University of Ferrara, had 65 of his patients undergo angioplasty to clear blockages. Of those patients, 50 per cent reported no attacks in the next 18 months. In a control group that did not have the surgery, the rate was 27 per cent.
Already, researchers in Canada and around the world are eager to test Dr. Zamboni's theory. Scientists in Europe and the Middle East say they are seeing malformed or blocked veins in MS patients. Researchers in Buffalo are expected to release their findings, which involved 500 subjects, shortly.
In Canada, the Multiple Sclerosis Society is receiving proposals for projects to test Dr. Zamboni's work. It will make $100,000 available annually for two years. The team in Hamilton and another at the University of British Columbia plan to apply for the grants.
Mark Haacke, director of the MRI Institute for Biomedical Research in Detroit and an adjunct professor at McMaster University, has been urging patients to send him MRI scans of their heads and necks. He will be working with the Hamilton team. He acknowledged Monday that Dr. Zamboni's theory may not provide all the answers to multiple sclerosis, but it could be a contributing factor. "It behooves us to investigate it further," he said.
Multiple sclerosis is a degenerative condition that can cause loss of balance, impaired speech, extreme fatigue and paralysis.
Caroline Alphonso