The overall goal of this project is to assess genetic and immunological factors that contribute to the pathogenesis of neurological disease. Particular attention is focused on multiple sclerosis (MS), since this disease is thought to have an immunological basis. Both genetic and immunological factors are being examined in patients with well- characterized clinically definite MS. In addition to studies in sporadic patients, members of multiplex families with multiple affected members and patients with identical or nonidentical twins either affected or nonaffected with MS are also being studied. Various forms of immunosuppressive therapy are being examined in the treatment of MS. These studies employ MRI as a means for monitoring efficacy of treatment. The clinical course and potential treatment of patients with HTLV-I associated myelopathy-tropical spastic paraparesis is being evaluated, since this disease may represent an example of virus-induced immunopathological disease. The presence of clinical disease is being correlated with the evidence of immunological abnormalities which may reflect an immunopathological process. New innovative therapies designed to reduce the number of activated T cells are now being initiated.
