SGU Episode 362

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SGU Episode 362
23rd June 2012
(brief caption for the episode icon)
SGU 361                      SGU 363
Skeptical Rogues
S: Steven Novella
B: Bob Novella
R: Rebecca Watson
J: Jay Novella
E: Evan Bernstein
P: Perry DeAngelis
Guest
Z: Professor Zhong Lin Wang
Quote of the Week
I believe in nothing, never have, never will. What matters is what I can see, hear, smell, taste, touch. Tangible things, physical things, reality. The rest is imagination.
Wolverine
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Introduction

You're listening to the Skeptics' Guide to the Universe, your escape to reality.

This Day in Skepticism (0:39)

History.com: Hudson set adrift by mutineers

News Items

Mystery Carbon Spike (6:17)

Nature: Mysterious radiation burst recorded in tree rings

Younger Dryas Impact (10:17)

The Daily Mail: Meteorite storm 'smashed the Earth 12,000 years ago and killed off a prehistoric people'

Liberation Procedure Study (16:05)

Science-Based Medicine: Liberation Procedure for Multiple Sclerosis

S: So I have a bit of an update on CCSVI. You guys remember what that is?

E: That's that show on CBS. They solve crimes.

S: Chronic cerebrospinal venous insufficiency.

E: Oh, that too.

S: So, in 2009, Dr. Paulo Zamboni, who's an Italian vascular surgeon, published a paper in which he claimed that 100% of MS patients that he investigated showed signs of venous blockage. And he concluded that--

J: Venous?

S: Yeah, so blockage in the veins that drain blood from the brain cause back pressure on those vessels and that leads secondarily to the inflammation and damage that we see in multiple sclerosis, in MS. This is a radical departure from the last 50 years of research into MS, which says that the inflammation is primary, that it's an autoimmune disease, although this isn't the first time that people have proposed these paradigm-changing hypotheses of what's really causing MS, but those have all crashed and burned over the years as well. The claim was met with immediate skepticism, as you might imagine. It's an extraordinary claim; it's like, "never mind those past 50 years of research; this one preliminary study I've found something completely different."

E: Yeah, just 'cause he found it in 100% of his patients; what'd he look at, three people?

S: No, he looked at a number of people, but the other wrinkle to this, which is-- doesn't mean he's wrong, but it does raise an eyebrow-- is that his wife has MS. He set out to find a cure for MS and he found one that happened to be in his specialty as a vascular surgeon. It's all a little convenient, you know what I mean? But regardless, the data was preliminary and... we had to say "OK, let's see if it's replicated." Over the last three years, his finding of 100% correlation was never replicated. And that was also, I think, a red flag. You know, 100%, we never see that in medicine; it's just too messy. Which suggests that there's significant researcher bias there, and if bias can explain some of the findings, maybe it can explain all of the findings. In any case, there have been a number of studies finding a range of percentages of patients with MS with some level of venous blockage, from 0% in some studies to like 20-40%, where most studies come down. However, healthy controls also have similar rates of venous blockage, or patients with other types of neurological disease that don't have MS. So, the correlation's very imperfect; it's highly variable; it depends a lot on what technique you use to look at the veins, because there's different ways you can look at it: Doppler, ultrasound, or MRI scan or angiography. The evidence, I think, overall is basically negative, but maybe there's some correlation with MS. What I suspect is that if this effect, which is much smaller than what Zamboni suggested-- if it is real at all, than it's probably incidental; it's just, yeah there's inflammation around the blood vessels and maybe that causes some scarred veins but it's not pathogenic, all right; it's not causing MS, it's just a consequence of it. What's really interesting from a skeptical point of view is that-- so you have a lone researcher proposing a radical new hypothesis based upon pretty flimsy evidence; it's not really being replicated very well; the data is mixed but tending to be generally negative, and it's being met with an appropriate level of scientific skepticism. But among a sub-group of MS patients, the reaction has been to conclude that this is the cause of MS, treatment of it is a potential cure, and it's being suppressed by neurologists to protect their sort of monopoly over MS, and of course, they're in bed with Big Pharma. Right, so this is--

B: Right.

S: Turf war and Big Pharma protecting their drug profits. Every article online about this issue is filled with comments from people saying: One, anecdotal evidence, which is worthless. "Hey, I got the treatment and I feel a little better." And two, raging conspiracy theories based on absolutely nothing. Meanwhile, there's actually been quite a bit of science on it in just three years for a theory that nobody really thinks is that plausible. There's been about a hundred or so actual studies of it, so it's actually been quite thoroughly investigated, which goes against the conspiracy-mongering notions that it's being suppressed or ignored or whatever. It's like, despite the fact that we don't think it's very likely, people are studying it just to make sure, to give it its due diligence. They're just not finding impressive results. There was one interesting study recently where they tied off the jugular veins in mice. So if you think back pressure from narrowing of the jugular veins is causing MS, you should be able to cause MS in mice by tying off their jugular veins. They did that; it caused nothing; it caused no problems, no back pressure, no demyelination, none of the kinds of findings or deficits that you would see in MS. So that's a pretty strong mark against it. It's also interesting, the different ways you could answer-- ask this question, you know, the animal model versus the clinical data. The news item here is that there was a recent study conducted in Canada, where patients have been the most vociferous in demanding this procedure-- called the "liberation procedure", opening up the veins, the blocked veins. The government essentially bowed to public pressure and allocated $400,000 to study this and now we're getting some preliminary results from this study; the data so far looked at 30 individuals with MS who got the liberation procedure, compared to 10 controls who didn't, and they found there was no benefit at all from the procedure. Interestingly, four of those patients actually had clots form in the jugular veins, so the jugular veins clotted off and became totally blocked after the procedure, which is one of the possible complications, and their MS did not worsen. So again, you would think, if MS was caused by the blockage, that would have been associated with the worsening. So, blocking off the veins didn't make it worse, opening up didn't make it better, pretty devastating evidence against the whole concept. And whatever you think about the concept, the treatment didn't work.

B: It reminds me of chiropractic, Steve, and why quadriplegics or paraplegics don't have multiple organ failure, because--

S: Yeah.

B: It's like, hello, that's kind of a death blow to your theory.

S: Yeah, if you think that the subtle subluxations and nerve impingements can cause organ failure, then what about people whose entire spinal cords are crushed? They seem to do fine. It's incompatible with subluxation, innate intelligence theory. I think the results of this study are fairly incompatible with Zamboni's MS theory. So, you know, it's being researched; it's being given more, I think, research attention than it really deserves, just from the plausibility of the science and the preliminary studies, because of the public interest, which raises an interesting question: how much scientific research, especially clinical studies like this, should be driven by public interest versus scientific plausibility?

J: I would say zero public interest.

S: Yeah, but then people are clamoring for this procedure and they want answers, you know?

J: Well, we all want answers to something, it just boils down to "where's the science".

R: Yeah, but whether or not it's true doesn't determine public interest, unfortunately.

S: I do think that this kind of data will marginalize it. My concern is that it's going to be marginalized but not disappear. So, historically for example, we can go back to the 1970s, when researchers proposed the notion--

B: Laetrile?

S: Well, you can go-- yeah, laetrile or psycho-motor patterning; you know, you can improve children who have developmental delay by passively taking them through the crawling stages to try to stimulate the brain to develop. Completely wrong; the studies showed it has zero effect, it doesn't work. It's still around today on the fringe; the scientists who came up with the idea just started their own institute and are still doing it today. So, in 20 years, is Zamboni or his acolytes going to be doing liberation procedures to treat MS on the fringe? You know, that's-- I'm interested to see if this is going to play out the same way. Or, when the data really comes back negative, is he going to acquiesce to the data and say "OK, it was a nice idea but I was wrong"? He doesn't seem to be--

R: Yeah, let's hope that Zamboni puts his theory on ice.

B: Ohhhh!

(laughing)

S: Waiting for that one, right? It would be really sad if this becomes a fringe treatment, but you know, the patients are seeking out the treatment despite the lack of evidence for it. It's also-- it's not risk-free; there have been two deaths in Canadian patients who have gotten the procedure; it can cause serious complications. So, it's not risk-free; if you do a risk-benefit analysis right now, the data is really against it. The FDA put out a warning saying, "don't do this; the risk versus benefit is not there."

Testing Female Athletes (25:48)

EurekAlert.com: Proposed testosterone testing of some female olympians challenged by Stanford scientists

Interview with Zhong Lin Wang (35:28)

Ideas, Inventions and Innovations: Ancient Effect Harnessed To Produce Electricity From Waste Heat

Audible Podcast advertisement (48:54)

• http://audiblepodcast.com/skepticsguide

Who's That Noisy? (50:41)

Answer to last week: Baby rhinos

Questions and Emails (54:32)

Fetal Pill Update

A few weeks ago you referenced and discussed an article that came out of South Korea, concerning the seizure of shipments of pills that contained ground human foeti (correct spelling of the plural of foetus?) that had been sent from China. The comment was made and I'm sorry but I forget by whom, that aside from the lack of fact checking there was a lack of information to back up the Asian/Eastern medicine beliefs extending to human body parts. Those beliefs being, that the consumption of certain parts of humans provide medicinal benefits much in the way eating birds' nest soup or shark fin soup, or dried tiger penis will impart some sort of advantage. I have come across some information that would state otherwise. Now I recognize that it is coming from a tertiary source, but the research of this source tends to reputable. Joel Brinkley, Pulitzer prize winning author and journalist of "Cambodia's Curse" references just such a belief. His references is a Chinese bureaucrat sent to the Angkor kingdom in the year AD 1295 and 1296 by the name of Zhou Daguan. On page 21 of "Cambodia's Curse" Brinkley makes expressive mention of Cambodians, the Vietnamese (Champa) and others eating human body parts. There is even mention of this continuing well into the 20th century. The belief in various parts of the body being inhabited by spirits remains strong in Cambodia and other parts of SE Asia. This article from the Phnom Penh Post, provides further evidence and perhaps discussion: (link unavailable). So, presumably the feotal tablets are not inconceivable knowing the value ascribed to human life and those of others and the beliefs in certain types of medicine that persist here in Asia. I of course being a "barang" (foreigner) am not privilege to all of these beliefs and can only provide anecdotal evidence based upon my observations, but as I said before the pills made of human babies is possible. Thank you for your time and keep us thinking.

Greg Pellechi Phnom Penh, Cambodia

Science or Fiction (59:18)

Item number one. A recent review of evidence concludes that, contrary to common belief, fathers in centuries past were nurturing and heavily involved in child care. Item number two. A new study finds that children born to older fathers have a longer life expectancy. And item number three. A review of over 500 studies concludes that a nurturing and accepting relationship with one's father is often more important to healthy psychological development than with one's mother.

Skeptical Quote of the Week (1:14:31)

I believe in nothing, never have, never will. What matters is what I can see, hear, smell, taste, touch. Tangible things, physical things, reality. The rest is imagination.

J: Wolverine!