Page last updated at 12:06 GMT, Thursday, 11 February 2010

'I had controversial MS treatment twice'

Graham Satchell
Correspondent, BBC Breakfast

Gianfranco Campalani
Heart surgeon Gianfranco Campalani says the treatment gave him quick results

A team in New York has reported the first results of a trial to test the theory that restricted blood flow in the brain may underlie some of the symptoms of multiple sclerosis.

Gianfranco Campalani knows a thing or two about the vascular system.

He's one of Northern Ireland's leading heart surgeons.

He was diagnosed with multiple sclerosis (MS) in 1986 - it left him with a series of problems in his lower body.

He finds it hard to walk more than fifty yards, or he did until he met an Italian compatriot and fellow vascular surgeon Professor Paolo Zamboni.

New theory

Professor Zamboni has pioneered a new theory of the cause of MS and has suggested a potential new treatment.

MS has always been thought of as an autoimmune disease.

For reasons that are not clear, the bodies' immune system attacks nerve cells in the brain which send messages to the rest of the body.

Professor Zamboni starting investigating MS when his wife was diagnosed with the condition.

He discovered she had constricted jugular veins in her neck.

His theory is that the narrow veins decrease the flow of blood from the head.

Pressure builds up in the smaller vessels in the head leading to deposits of toxic iron from the blood which cause damage in the brain.

He then tested a further 65 patients with MS and found they all had twisted or constricted jugular veins.

Gianfranco was one of those patients.

Chance meeting

They met three years ago in Italy when Gianfranco was visiting his brother - they all come from the same town - and the conversation soon turned to MS.

Prof Zamboni invited Gianfranco to be tested.

What happened at the clinic was electric.

"I nearly kissed him!" Gianfranco said. "It's funny, somebody tells you you've got something wrong and you are so happy.

"Finally you realise MS is not a disease of unknown origin. It's due to these anomalies in the veins which are present from birth."

A year later Gianfranco returned to Italy for treatment.

The angioplasty was carried out under local anaesthetic. Gianfranco watched it happening.

Dramatic effect

A small balloon was positioned in the vein and slowly inflated.

Image of jugular vein
The constricted vein was treated by angioplasty

When the balloon is removed, the vein - which was constricted - was a normal width and the blood flows more freely.

The effect was dramatic.

"Five hours after the procedure I got up and I walked the corridor without my stick.

"My partner cried.

"She never saw me walking like that.

"I was walking before the procedure but with a lot of difficulty.

"I was not able to lift my leg easily.

"But five hours after the procedure I can walk without my stick, I can lift my leg, my back is stronger I'm taller.

"In the subsequent days and weeks I see that other functions which were not working 100%, they work."

Last year, Gianfranco felt his condition worsen.

He asked colleagues in Belfast to check his jugular veins.

They had both constricted again.

He had a repeat angioplasty in Belfast in October and claims to have improved.

Questions

Yesterday researchers at the University of Buffalo revealed early findings from 500 patients.

They found that 55% of patients with MS had narrow veins in the neck - twice as much as healthy people.

Zamboni's theory and the new research from America raises many questions.

Is this a new explanation for the cause of MS?

Is angioplasty of the jugular veins a potential new treatment ?

Many experts are sceptical.

They say at this stage there is no proof of a causal link between blood flow and MS.

There is uncertainty about the level of pressure needed in the blood vessels in the brain for red cells containing iron to cross the blood brain barrier.

The MS society says there have been no clinical trials of the procedure and much more work is needed.

"We need more investigation - more scientific research into cause and effect," Gianfranco acknowledges.

But for him, Prof Zamboni has opened up a new way of looking at MS and one that has improved his life.



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