Dr. Paolo Zamboni , whose revolutionary research into Multiple Sclerosis suggests that it is a vascular disease rather than a autoimmune condition, is seen here at the American Academy of Neurology Conferece in Toronto Wednesday April 14, 2009.Tim Fraser for The Globe and Mail
The Italian doctor who gave multiple sclerosis sufferers hope their condition could be treated with a simple procedure - and prompted many of them to cross borders and shell out thousands of dollars to receive it - has now warned patients against receiving the treatment until further clinical trials have been conducted.
Paolo Zamboni, a researcher at the University of Ferrera, has posited that the improper drainage of blood from the brain, termed chronic cerebro-spinal venous insufficiency, may play a part in causing MS, which is generally believed to be an autoimmune disease.
If Dr. Zamboni's hypothesis is true, it would suggest MS can be treated by opening up the blood vessels to the brain - a procedure dubbed "liberation therapy."
According to NeuroSens, a subscription-based news service on neurological matters, Dr. Zamboni told an MS conference in Gothenburg, Sweden, that patients shouldn't go ahead with such surgery, except in the case of clinical trials.
"Surgery is not recommended at this stage," he said, during a presentation this week to the Congress of the European Committee for Treatment and Research in MS.
He also said he does not support "medical tourism" - the practice of some patients who travel overseas to clinics that will perform the surgery. Thousands of people are believed to have done this.
Those who believe in the theory, however, said Dr. Zamboni's caution likely won't change the minds of those who are determined to receive surgery to open their blood vessels.
Duncan Thornton, a Winnipeg advocate of the surgery, said that, with few other options on the horizon, MS sufferers were compelled to get the treatment.
"Certain cautions are warranted. There are going to be places that will be better and worse," he said. "You can phrase those cautions as strongly as you like, but medical tourism can [only]be avoided if you can have this procedure in Canada."
Skeptics have argued that such an operation is too dangerous when it hasn't been conclusively proven to produce results. Mr. Thornton and other advocates argue the procedure isn't particularly dangerous and patients should be allowed to assess the risks themselves.
Mr. Thornton, an MS sufferer himself, underwent a balloon angioplasty in Poland in March. He said many of his symptoms have been alleviated, that he can think more clearly and, within moments of receiving the treatment, his hands and feet felt warmer.
Lori Lumax, a Regina woman who has MS, wants liberation therapy, but said she hopes to have it done in Canada if clinical trials get underway.
She said Dr. Zamboni's caution had merit, but that some sufferers aren't willing to wait.
"It would be safer [to wait] you would be making a better decision if you had all the facts," she said. "Personally, I think this is the same thing he's said all along -- he never wanted a rush on the process, he wants this treatment studied.
Canada is currently doing extensive research into the chronic cerebro-spinal venous insufficiency theory. The MS Society of Canada and the U.S. National MS Society have committed $2.4-million to fund seven studies. The studies are examining the structures of veins in MS patients and checking for iron deposits in the brain, in hopes of determining if Dr. Zamboni's theory has merit.
Saskatchewan has gone a step further, saying it would fund a clinical trial of liberation therapy, while Newfoundland and Labrador has announced its intention to monitor patients who have had the procedure to assess its effectiveness.
Dr. Zamboni's hypothesis remains highly contentious, with critics arguing that the procedure gives MS patients false hope.
Adrian Morrow