Inclusion criteria, exclusion criteria and study summary
Multiple sclerosis (MS) is a common disease which affects the nervous system and causes disability. There is no cure. MS symptoms can come and go and have a big impact on daily life. This study will examine MS symptoms and the different reasons they might get worse. This will help doctors give better treatment to people with MS. The brain is separated from the body by the blood-brain barrier (BBB). If the BBB is leaky the function of the brain can be affected. This could be caused by problems in the body such as infections. Inflammation might be the reason for this, as the body tries to fight the infection but could accidentally damage the BBB. In people with MS, the BBB is already leaky. It could more vulnerable to damage during an infection. This might explain why people with MS can have their symptoms worsen during an infection, sometimes dramatically. However, healthy people might also experience this effect. Almost everybody has experienced feeling terrible during a bout of flu, with tiredness and foggy thinking. This is called sickness behaviour, and might be related to leakiness of the BBB. We want to understand these problems, and why they happen. We hope this will help develop new ways to prevent and treat these problems. People with MS and also people with no brain disease will be observed for up to five years. Symptoms will be closely recorded. Blood and urine samples will be used to measure the amount of inflammation in their body. Magnetic resonance imaging (MRI) brain scans will be used measure changes in BBB leakiness. This will all be done when they are feeling well, and also during infections and MS exacerbations.