MR Perfusion Imaging and Hypercapnia (Increased Carbon Dioxide) to Study New Blood Vessel Formation in Multiple Sclerosis

INCLUSION CRITERIA (NORMAL VOLUNTEERS) Any healthy volunteer above the age of 18 who is capable of giving informed consent recruited or self referred through the NIH Volunteer office will be eligible for this study. All healthy normal volunteers will be required to fill out the questionnaire in Appendix B. Normal volunteers will be included as long as they have no recorded or documented signs or symptoms of CNS disease, contraindications to an MRI and have a 'normal age-appropriate' MRI of the brain. Only patients seen in the Neuroimmunology MS clinic with a confirmed diagnosis of Multiple Sclerosis based upon previous history of two clinical neurological attacks separated in time and in spatial location or combination of Clinical and MRI findings of a single enhancing lesion in the brain or spine along with multiple T2 hyperintensities in the juxtacortical, periventricular or infratentorial white matter according to the McDonald criteria will be included in this study. Relapsing-remitting or secondary progressive MS who have had more than one relapse within 18 months preceding study enrollment will be recruited from the MS 7th floor clinic in the NINDS at the NIH. MS patients EDSS score between 1.0 - 6.5, inclusive. Give written informed consent prior to any testing under this protocol, including screening/pre-treatment tests and evaluations that are not considered part of the patient's routine care. EXCLUSION CRITERIA: Healthy Controls and MS patients will be excluded if they have contraindications to MR scanning, such as the following: pacemakers brain stimulators dental implants aneurysm clips (metal clips on the wall of a large artery) metallic prostheses (including metal pins and rods, heart valves, and cochlear implants), permanent eyeliner implanted delivery pump shrapnel fragments Welders and metal workers are also at risk for injury because of possible small metal fragments in the eye of which they may be unaware. You will be screened for these conditions prior to the study, and if you have any of these conditions, you will not receive an MRI scan. If you have a question about any metal objects being present in your body, you should inform the physician. Healthy controls and MS patients will be excluded from this study if they have the following: History of panic disorder History of migraine (because of possible complications with CO2 inhalation). Subjects who have a history of a reaction to MR contrast agents specifically gadopentetate dimeglumine will be excluded from participating in the contrast agent administration part of this protocol. Subjects will also be excluded from the study if they are presently taking indomethacin or acetazolamide which effects the carbonic anhydrase system of endothelial cells in the brain making them unresponsive to CO2 inhalation. Subjects will be excluded if they have a previous history of panic attacks. Healthy controls and MS patients will be excluded if have history of alcohol or drug abuse. Healthy controls and MS patients will be excluded if concurrent, clinically significant (as determined by the investigator) cardiac, immunologic, pulmonary, neurologic, renal, and/or other major disease. Healthy controls will be excluded if they have a previous known abnormality on brain MRI examination Pregnant and lactating women will be excluded from the study. MS patients will also be excluded from study entry if the following exclusion criteria exists at the time of enrollment: 1) Diagnosis of primary progressive MS, defined as gradual progression of disability from the onset without relapses.