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November 23, 2009 07:26  by Dr. Lorne Brandes

We all know the Greek word “eureka”. Loosely translated, it means “I’ve found it.” 

Eureka has become synonymous with “epiphany” (in the non-religious sense of the word), variously defined as an intuitive grasp of reality through something (as an event) usually simple and striking; an illuminating discovery, realization, or disclosure; or a revealing scene or moment. 

The first “eureka moment” in science is ascribed to Archimedes. In approximately 250 BC, the Greek mathematician noted that his bath water rose several inches and slopped over the edges as he stepped into the tub. While most other mortals would have simply picked up the bar of soap and got on with it, Archimedes had the sudden epiphany that the volume of bath water he displaced was equal to the volume of his body. 

That simple observation, which changed the physics and mathematics of measurement forever, became known as “Archimedes’ Principle”. (Greek lore has it that, in his excitement, Archimedes ran through the streets naked, yelling, “Eureka!”)

Let us now fast-forward to November 21, 2009, when a eureka moment shook the world of Multiple Sclerosis.

Appearing on CTV’s W5, the network’s medical specialist, Avis Favaro, told the compelling story of a discovery so amazing, so seemingly out of the blue, that viewers, including me, were left speechless.

Read more on the W5 webpage: The Liberation Treatment

In a nutshell, Dr. Paolo Zamboni, an Italian vascular surgeon at the University of Ferrara, has accumulated convincing ultrasound evidence that every MS patient he has examined, some 120 in all, have blockages in one or more neck or chest veins that drain blood from the brain back to the heart. Healthy subjects, or patients with neurological diseases other than MS, do not show these anomalies.

Not only does the venous blood not drain properly in patients with MS, it often backs up in the diseased vessels (called retrograde flow), causing congestion of the veins deep in the brain. 

Dr. Zamboni postulated that, as a result of this reversed blood flow, the thin-walled veins leak blood into the surrounding brain tissue, resulting in active MS lesions, called plaques. In suggesting this, he drew from his knowledge of previously published autopsies on the brains of MS patients showing that plaques always form along venous pathways, and that a vein is always in the centre of an MS plaque! Recent MRI studies have reconfirmed these observations.

How does leaking blood cause MS plaques? Blood is rich in iron; when iron gets into the brain tissue it is very toxic, causing inflammation around the insulating cells (myelin sheaths) that coat delicate nerve bundles. The result is a “short-circuiting” of electrical activity in the nerves and, in the worst case scenario, cell death. 

Could iron toxicity from leaked blood be at the root of MS? Dr. Zamboni thinks it is.

He well may be right, according to Dr. Mark Haacke, affiliated with Hamilton’s McMaster University and Detroit’s Wayne State University. Using a special technique called susceptibility weighted imaging (SWI), Haacke and his colleagues discovered that MS plaques contain significant amounts of iron.

But isn’t MS primarily an autoimmune disease? Professor Zamboni believes that inflammation of the brain tissue, caused by the iron, is the primary event that secondarily turns on the immune system, adding to the damage. Opening the blocked veins to prevent further blood leakage and iron deposition, rather than giving immunosuppressive drugs, should be the best way to treat MS and prevent further attacks.

Now, in a “proof of concept” study, published in the Nov. 24th edition of the Journal of Vascular Surgery, Dr. Zamboni and his team report on the outcome of unblocking the veins in 65 patients. Thirty-five patients with the less severe, remitting-relapsing form of the disease, followed for at least 18 months, experienced a dramatic improvement in their symptoms and energy. Those whose veins remained open in the months after the procedure had no further MS attacks, and came off their steroids and other medications. At the same time, their MRI scans showed a dramatic drop in the number of MS plaques.

Perhaps with an eye on history, Dr. Zamboni’s co-author, Dr. Fabrizio Salvi, has dubbed the unblocking operation the “liberation procedure”: liberating the veins from blockage while (hopefully) liberating the patients from their disease. Yet, Dr. Zamboni is not claiming a cure. He is simply asking the medical world to put skepticism aside, reproduce his vein flow studies and assess his unblocking treatment as quickly as possible. The knowledge that hundreds of thousands of MS patients might benefit from his discovery weighs heavily on him. 

Happily, researchers at the University of Buffalo have taken up the challenge, with Stanford University scientists about to do likewise. In Canada, McMaster’s Dr. Haacke is inviting MS patients to send him their MRI scans for his review.

And what is the reaction of the National MS Societies in Canada and the United States? If their official response to Dr. Zamboni’s research was any cooler, icicles would form on their spokespersons’ lips. Why am I not surprised? These organizations are big money operations, run by risk-adverse professionals and fundraisers who are absolutely petrified of making a mistake and prematurely backing a losing horse. Their interests are also heavily intertwined with those of Big Pharma, which has invested billions of dollars in developing immunosuppressive treatments for MS, such as Betaseron.

In a similar vein (excuse the pun), when Australian researchers Robin Warren and Barry Marshall published striking evidence in the 1980s that a previously unclassified bacterium, now called Helicobacter pylori, was the main cause of stomach and duodenal ulcers, they were greeted by a wall of silence.

At the time, the scientific community universally believed that stress and hyperacidity were the culprits. Not surprisingly, the importance of this contrarian discovery was further minimized by drug companies with a vested interest in chronic antacid therapies, not in a curative course of antibiotics. 

Happily, the two researchers persisted in their work and converted the scientific community into believers. As a reward for shifting the paradigm, they received the 2005 Nobel Prize in Medicine. It appears that some Eureka moments take a long time to be considered as such.

In  discussing “The Scientific Method”, Dallas Baptist University professor, Dr. David Naugle, provides us with two memorable quotes: Sherlock Holmes once said to Watson: "You see, but you do not observe!" And Helen Keller similarly stated to a friend: "How tragic it is to have sight, but to lack vision!" Naugle goes on to point out that by overlooking the smallest clue or detail, we may miss the key to solving the problem.

Well put. Paolo Zamboni had the vision to observe what was always there, something simple and striking, yet unseen by everyone else. He came, he saw, he had an epiphany. Let us hope that when the final study results come in, we will all join Dr. Zamboni in shouting, “Eureka”!

For info on taking part in upcoming studies on CCSVI, read W5's Question and Answer page.

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Dr. Marla Shapiroclose [x]

Dr. Marla Shapiro, MDCM CCFP MHSc FRCP(C) FCFP, is a family physician and the Health and Medical Contributor for CTV's Canada AM as well as the editor of Parents Canada magazine, launched in March 2007.

She completed medical school at McGill University and trained at the University of Toronto for her Masters of Health Science in Community Health and Epidemiology. She holds a Fellowship in Family Medicine and is a NAMS credentialed menopause specialist. She is an associate professor in the Department of Family and Community Medicine at the University of Toronto, where she recently won an award for Creative Professional Activity.

Dr. Shapiro won the Society of Obstetricians and Gynaecologists of Canada/Canadian Foundation for Women's Health Award for Excellence in Women's Health Journalism in 2006 for her documentary "Run Your Own Race." Her book, "Life in the Balance: My Journey with Breast Cancer" was released in the fall of 2006 and is a national bestseller.

For her lifelong commitment to family medicine, Shapiro was awarded the College of Family Physicians of Canada's Award of Excellence for 2008.

Angela Mulhollandclose [x]

Angela Mulholland is the editor of CTV News' semi-weekly health newsletter MedNews Express as well as the MedNews Express Blog.

She has been a journalist for CTV News since 2000, covering current affairs, health and entertainment for CTV.ca. Before CTV, she worked for CBC.ca for two years.

She has a degree from St. Jerome's University in Waterloo, ON, and studied journalism at Sheridan College in Oakville. She lives in Toronto with her husband and two children.

Monica Matysclose [x]

Monica Matys has been the health and wellness reporter for CTV News Toronto since 2001. Her feature health report, Lifetime, can be seen on CTV Toronto's News at Noon and at 6 p.m.

Her interest in the medical field began while working for a medical publishing company as the editor of a monthly magazine. One of Monica's favourite days on the job was the time she got to spend a day in Credit Valley Hospital's Emergency unit. "It really opened my eyes to the strains on our system," Monica explains.

Matys grew up in Scarborough, and has an honours degree in Journalism from Carleton University in Ottawa. She lives in Toronto with her husband and two children.

Avis Favaroclose [x]

Avis Favaro has been with CTV News since 1992, producing stories for CTV National and CTV News Channel - Newsnet- as well as for CTV affiliate stations across the country.

Avis and producer Elizabeth St. Philip won the 2008 Media Awards for Excellence in Health Reporting handed out by the Canadian Nurses Association and the Canadian Medical association for a story on BPA found in food cans.

She has been nominated for an impressive 12 Geminis, winning once for a unique story on an experimental cancer treatment developed in Winnipeg in the 1940's.

Avis has a masters in journalism from UWO and a Bachelor's degree in History, and launched her journalism career as a writer/reporter at Global in 1982.

Dr. Yoni Freedhoffclose [x]

Dr. Yoni Freedhoff, MD CCFP Dip ABBM, is the founder and Medical Director of the Bariatric Medical Institute in Ottawa, a multi-disciplinary behavioural weight management program. Formally trained in family medicine, since 2004 his practice has been exclusively dedicated to the treatment of overweight and obesity.

Dr. Freedhoff has been referred to as a "nutritional watchdog" by the Canadian Medical Association Journal and a national "obesity expert" by the Canadian Obesity Network. His advocacy efforts for improved public policies regarding nutrition and obesity have found him testifying in front of the Canadian House of Commons, giving press conferences with the Ontario Medical Association, commenting regularly in the national media, and as a sought after lecturer.

Dr. Freedhoff explores issues pertinent to nutrition, obesity, public policy and advocacy in his daily blog Weighty Matters which is ranked among the world's top health blogs and was voted the top Canadian health blog of 2008 by the Canadian Blog Awards.

Dr. Grant Lumclose [x]

Dr. Lum is a sports medicine physician. He is the medical director and founder of Athletic Edge Sports Medicine, a multidisciplinary sports medicine organization offering services to the athletic and active public.

He is involved in the care of recreational, elite amateur and professional athletes, including players in the NHL, NFL and NBA. He is also involved in the performing arts medical community, taking care of musicians, vocalists, dancers and other performing artists.

Dr. Lum studied medicine at the University of Toronto, where he graduated in 1992. He completed a two-year residency in Family Medicine, and then specialty training in Sports Medicine.

He is a lecturer at the University of Toronto's Faculty of Medicine, an adjunct professor at York University's Faculty of Fine Arts, and medical director of George Brown College's Fitness and Lifestyle Management Program.

Dr. Lorne Brandesclose [x]

A senior oncologist at CancerCare Manitoba, Dr. Brandes received his MD from the University of Western Ontario in 1968.

Following post-graduate training at the Royal Marsden Hospital (London) and the University of Manitoba, he joined the faculty at U. Of M. in 1975, where he is a professor in the Departments of Medicine and Pharmacology.

He is also affiliated with the Manitoba Institute of Cell Biology.

Dr. Katy Kamkar, Ph.D., C. Psych.close [x]

Dr. Katy Kamkar, Ph.D., C. Psych., is a Clinical Psychologist at the Work, Stress and Health Program/Psychological Trauma Program, at the Centre for Addiction and Mental Health (CAMH). She also provides private practice at the CBT Associates of Toronto and is a lecturer in the Department of Psychiatry, University of Toronto.

She completed her Honours Degree in Psychology and Mathematics at York University and her Masters and Ph.D. in Clinical Psychology at Concordia University. She also completed a Clinical/Research Postdoctoral Fellowship at CAMH. She has received numerous academic awards and distinctions.

Kamkar provides consultation, comprehensive assessments, and evidence-based Cognitive-Behavioural treatment for Mood and Anxiety Disorders, including psychological distress related to stress and anxiety in the workplace. She also provides training, education, and supervision as well as various educational seminars and workshops. She adheres to a scientist-practitioner model of practice and integrates research and science with practice.

One of Dr. Kamkar's greatest interests has been to provide education to enhance public awareness of mental health/illness in general and of psychological distress in the workplace. She has written articles for comprehensive public resources and provided numerous public relations - media work.

Dr. Neil Rauclose [x]

Dr. Neil Rau grew up in Ottawa. He initially studied mathematics at the University of Waterloo before completing his MD at the University of Toronto in 1991. He completed training in Internal Medicine and Infectious Diseases at McGill University in 1996, before establishing a busy private practice in Oakville. He is currently the medical director of Infection Prevention and Control at Halton Healthcare Services.

In 2008, he completed his training in medical microbiology at the University of Toronto and he now serves as the medical microbiologist and chair of the patient safety steering committee at his hospital.

He is a lecturer at the University of Toronto. Since 2008, he has also been Infectious Diseases section head at the Association for Medical Microbiology and Infectious Disease Canada. He is also a frequent contributor to CTV News.

He lives in Toronto with his wife and two children, and is an avid amateur concert pianist.

Cara Rosenbloom, RD close [x]

Registered dietitian Cara Rosenbloom believes that nutrition can make a difference in overall health and wellness and enjoys translating complex nutrition information into usable and helpful advice.

Rosenbloom holds a literature degree from the University of Western Ontario and a Bachelor of Applied Science in Food & Nutrition from Ryerson University. She completed a dietetic internship at North York General Hospital to become a registered dietitian.

Prior to becoming a nutrition columnist, Rosenbloom worked as a dietitian at The Hospital for Sick Children for three years. She is a member of Dietitians of Canada and the College of Dietitians of Ontario and the president of Words to Eat By, a nutrition communications company.