Dr. Paulo Zamboni is a vascular surgeon. He has no special background or training in neurology or neurodegenerative diseases. Nor does he have background in the design of the human skull and the all the variations of the drainages systems. He is not a specialist in radiology or cranial hydrodynamcis either, nor is the idea of using ultrasound scans to check brain blood flow new. I was in a study group with a chiropractor in 1984 who was using plethymography doppler scans on all his patients before and after cervical care. It was a great device, but chiropractors couldn’t get reimbursed one cent for the procedure at the time. The current charges for the ultrasound exam for venous stenosis seems overly expensive compared to MR angiograms, which produce far more accuate and direct information. What Dr. Zamboni has contributed to MS research is the term CCSVI and the liberation procedure which has shown huge promise and potential. Other than that, he is a relative new comer to research into the cause of neurodegenerative disesases such as MS, including the role of venous drainage issues such as CCSVI. I have been writing about venous drainage issues for well over twenty years now.
Dr. Franz Alfons Schelling, on the other hand, is a retired Austrian physician who started in 1973 and spent his entire career studying MS. Interestingly, his investigation began when he noticed enormous differences in the venous outlets in skulls of patients with MS. His online book Multiple Sclerosis – The Image and It’s Message – The Meaning of the Classic Lesion Forms,” is a gem.
In contrast to Zamboni, Schelling belives that the cause of the lesions seen in MS are due to venous back jets into the brain; that is reverse or inversion flows. He believes the primary source of the back jets to arise from cardiorespiratory waves transmitted to the brain due to incompetant valves in th jugular veins, as well as through the vertebral veins, which unlike most veins, have no valves. He also discusses violent venous back jets from the cord into the brain due to truama as a source. Schelling’s theory of venous back jets explain the hyperintensity signal lesions seen in MS far better than Zamboni’s theory of venous stenosis, but I disagree with Schelling on the primary source coming from cardiorespiratory waves. I studied bats, whales and giraffes precisedly to study extreme inversion flows and found that they have adapted compensatory mechanisms, which I discuss in my book. Humans similarly contend with inversions flows.
In contrast to Schelling, my research began around 1984 while studying the unique designs of the bent base and special joints of the human skull called sutures. The artificially deformed skulls from Peru and Bolivia started me looking into hydrocephalus, which led to normal pressure hydrocephalus and Alzheimer’s disease. That led to Parkinson’s and later multiple sclerosis. When it came to my theory of venous drainage issues in neurodegenerative diseases, I was stumped by MS. It was difficult to explain the location of the supratentorial periventricular hyperintensity lesions seen near the core of the brain and conversely along the flanks of the cord in MS. Schelling provided the answers.
In brief, I agree in part with Zamboni on the theory of CCSVI but I disagree with him that stenosis of jugulars is the primary cause. I agree with Schelling that venous back jets most likely cause the lesions, but I disagree with him that the primary source of the back jets come from cardiorespiratory waves. I have my own theory about the cause of the CCSVI, which I think is better than either Zamboni of Schelling’s theory, but no one has all the answers, at least not yet. Nontheless, the current stir over CCSVI has been a huge leap forward for people afflicted with MS as well as other neurodegenerative diseases.
When it comes to the overall subject of the MS, Schelling is by far the expert and anyone involved in MS research should know everything in his book so that we are all on the same page. More than just describing the lesions and theories regarding their cause, Schelling make it clear what MS is not. According to Schelling and others for that matter, MS is not an immunological disease, nor is it due to inflammatory reactions. Corticosteroids most likely work on MS cases by reducing swelling and pressue, not inflammation, the same as it does in head trauma cases. But corticosteroids cause wasting and weaknesses of muscles and bones, which isn’t good considering MS patients often have problems with leg weakness, balance and falls. The last thing MS patients need is wasted muscles and broken bones. Interferon makes no sense either, since according to Scelling, except for oligoclonal bands in CSF, there is really no solid evidence to indicate that MS is an autoimmune disease.