CCSVI DATABASE SELF-REFERRAL PROGRAM
Thank you for your interest in our research projects which are designed to explore the link between MS and CCSVI. Chronic cerebrospinal venous insufficiency (CCSVI) is an ongoing problem when blood from the brain has difficulty flowing properly to the heart due to blockages or stenoses (narrowing of the veins).
You have an opportunity to self refer to our center for testing of CCSVI. The testing is presented as a complete regimen which includes:
MRI of the brain and neck: This MRI is designed to collected special pictures of your brain and neck. The MRI will last 60-90 minutes.
Doppler ultrasound: A non-invasive test that uses reflected sound waves to evaluate blood as it flows through a blood vessel. It helps doctors evaluate blood flow through the major arteries and veins of the arms, legs, neck and more recently with the new instruments also the flow trough the brain. It can show blocked, reduced or reversed blood flow through the major vessels of the neck and head. This exam will last about 45 minutes.
Clinical visit with a neurologist: You will have a physical examination which will include blood pressure, pulse, and functioning. You will be asked questions regarding your medical history as well as what medication you currently take and have taken in the past. There will also be questions about your MS diagnosis, symptoms, and relapse issues. The tests will evaluate disability associated with MS, leg, arm and cognitive function, and fatigue. The visit will last approximately 60 minutes.
Neuropsychological evaluation: You will complete a group of tests which are designed to assess memory, cognitive functioning, hearing, verbal learning, motor function and mood. This testing takes about 2 hours.
Blood sample: You will be asked to contribute 2 tablespoons of blood for evaluation of specific genetic factors related to higher MS disease susceptibility and severity.
At this time, there isn’t any health insurance reimbursement for any testing component. The total cost of testing and reports is $4500.00. We kindly ask that 50% of this is paid prior to scheduling.
Research evaluating CCSVI and MS is not complete and is, in fact, only in its initial stage. By signing up for testing, you will also agree to allow our team to use your test results to create a large patient database which will allow us to carefully evaluate the value of these procedures, according to the approved IRB protocol, in further understanding MS and any possible treatment that could follow.
You understand that you are voluntarily agreeing to undergo the tests.
If you are writing on behalf of a relative or friend, please instruct him/her to contact us directly at this email address: ccsvi.database@bnac.net
1) Inquiries to the ccsvi.database@bnac.net email will prompt an automated response with instructions to complete an online application.
2) If you do not have access to the internet, call 716-859-7040.
3) Applications will be processed in the order they are received and according to safety criteria
4) Once the team evaluates the information you provide in the application, you will be contacted to:
a) complete the screening and safety evaluation process
b) discuss schedule of procedures and payments
c) receive, review and sign consent agreements for testing, payment, results interpretations and use of your data for research purposes
d) organize your testing schedule
If you would like to start this process, please go to: http://vovici.com/wsb.dll/s/8727g42d33 to complete an online application. PLEASE SUBMIT ONLY ONE application per person. Any incomplete or duplicate applications will only delay the application process. This information is required for all applicants. Thank you for taking the time to complete the application.
