ISRCTN ISRCTN75786983
DOI https://doi.org/10.1186/ISRCTN75786983
Secondary identifying numbers 11/LO/1139
Submission date
17/10/2011
Registration date
14/11/2011
Last edited
27/04/2018
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Nervous System Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Multiple sclerosis is a disease of unknown origin causing disability in young adults. Recently differences in the blood flow in the neck veins have been described in multiple sclerosis. These can be found using a simple ultrasound scan that is safe and acceptable to most patients. The aims of this study are: to establish how common these findings are in a sample of UK multiple sclerosis patients; to establish if these findings are more common in multiple sclerosis patients than people without multiple sclerosis (called controls); to establish how variable ultrasound is in identifying these findings.

Who can participate?
30 patients of any gender over 18 years of age with any pattern of multiple sclerosis with an estimated disease severity score (EDSS) of 6 or less. 30 healthy controls with the same age and gender will also be tested.

What does the study involve?
The study will involve an initial examination by a neurologist to ensure that individuals are suitable to participate. There will then be a one hour ultrasound examination of the neck veins sitting and lying flat. This will be repeated after thirty minutes by a second sonographer.
All participants will be invited back for a second scan by one of the same sonographers.

What are the possible benefits and risks of participating?
Participants will not gain any direct benefit from participating. There are no side-effects.

Where is the study run from?
Imperial College London (UK).

When is the study starting and how long is it expected to run for?
The study will commence in November 2011 and recruit for 1 year, with results expected in early 2013.

Who is funding the study?
Royal College of Surgeons of England, the Circulation Foundation and the Venous Forum at the Royal Society of Medicine (UK).

Who is the main contact?
Dr Richard Nicholas
nicholas@imperial.ac.uk

Contact information

Dr Richard Nicholas
Scientific

MS Day Unit
4 North
Charing Cross Hospital
London
W6 8RF
United Kingdom

Study information

Study designSonographer blinded age-sex healthy control matched cross-sectional ultrasound study
Primary study designObservational
Secondary study designCross sectional study
Study setting(s)Hospital
Study typeScreening
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleCerebral venous drainage in multiple sclerosis: protocol for a blinded, age-sex matched cross-sectional ultrasound study
Study objectivesThere will be statistically and clinically significant differences in cerebral venous outflow disturbance between multiple sclerosis patients and healthy controls.
Ethics approval(s)UK National Research Ethics Board, 15/08/2011, ref: 11/LO/1139
Health condition(s) or problem(s) studiedMultiple sclerosis
InterventionAll participants will undergo a lying and standing blood pressure measurement and an electrocardiogram (heart tracing) on entry to the study.

All participants will then undergo a one hour ultrasound examination of the neck, comprising thirty minutes lying flat and thirty minutes sitting upright.

At the end of the examination the images will be stored for future analysis at a another time point, i.e. results will not be disclosed to the participant.

Any willing participants will be invited back for a future rescan in 2 weeks by one of the same sonographers. No further follow up is required for this study.
Intervention typeOther
Primary outcome measure1. Reflux (>0.88s) in the internal jugular (IJV) and vertebral veins (VVs) using triplex mode
2. High resolution B-mode evidence of IJV stenosis in transverse orientation (>50% cross-sectional area diameter reduction) with and without Valsalva
3. Undetectable Doppler flow in the IJVs and VVs using colour and Spectral Doppler
4. Cross-sectional area change of the IJV from the supine to sitting position
Secondary outcome measuresInter and intra sonographer reproducibility
Overall study start date01/11/2011
Completion date01/11/2012

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants60
Key inclusion criteria1. 18 years of age or greater
2. Informed consent
3. Cases: multiple sclerosis by McDonald criteria with estimated disease severity score < 6, any disease pattern
4. Controls: no other relevant health condition
5. Ability to perform Valsalva manoeuvre
6. Stable disease for one month pre-recruitment
Key exclusion criteria1. Concurrent enrolment in multiple sclerosis drug trial
2. Concurrent masking neurological disease
3. Pregnancy
4. Inability to lie supine
5. Intercurrent infection
6. Superior vena cava obstruction
7. Tricuspid regurgitation
8. Right heart failure
9. Vasculitis
10. Treatment with venodilators (e.g. nitrates)
11. Head and neck surgery or radiotherapy
12. Previous central venous catheterisation
13. Previous central venous thrombosis
14. Thrombophilia
15. Arrhythmia on baseline electrocardiogram (ECG)
16. Postural systolic drop of >30mmHg on standing
17. Steroid treatment within one month
18. Pulmonary hypertension
19. Malignancy
Date of first enrolment01/11/2011
Date of final enrolment01/11/2012

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Charing Cross Hospital
MS Day Unit
4 North
London
W6 8RF
United Kingdom

Sponsor information

Imperial College London
University/education

Joint Research Office
Exhibition Road
London
SW7 2AZ
England
United Kingdom

ROR logo "ROR" https://ror.org/041kmwe10

Funders

Funder type

University/education

The Royal College of Surgeons of England

No information available

The Venous Forum at the Royal Society of Medicine

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Editorial Notes

27/04/2018: No publications found, verifying study status with principal investigator.
18/03/2016: No publications found, verifying study status with principal investigator.