Physiological Effects of N-Acetyl Cysteine in Patients With Multiple Sclerosis

Prior treatment

• Patients are excluded who have received treatment with intravenous steroids within the past 90 days for reasons other than MS
• Previous brain surgery that would interfere with determination of cerebral metabolism or structure on the FDG PET-MRI.
• Patients with current alcohol or drug abuse
• Enrollment in active clinical trial/ experimental therapy within the prior 30 days.
• Pending surgery during the course of the study.
• Currently using medications that might alter the distribution of radiopharmaceuticals in - -the body or brain (as determined by Investigator)

Other illness

• Intracranial abnormalities that may complicate interpretation of the brain scans (e.g., stroke, tumor, vascular abnormality affecting the target area).
• History of head trauma with loss of consciousness \> 48 hours.
• History of asthma requiring daily medications for adequate management.
• Any medical disorder or physical condition that could reasonably be expected to interfere with the assessment of MS symptoms, or with any of the study assessments including the PET-MRI imaging.
• Patients with evidence of a significant psychiatric disorder by history/examination that would prevent completion of the study will not be allowed to participate.
• Patients taking medications that might interact with NAC involved in this study will be evaluated on a case by case basis by the PI or study physician. These medications include: Medications for high blood pressure; Medications that slow blood clotting; Medications for diabetes; Nitroglycerin.
• Patients with history of pulmonary hypertension.
• Any neurological, psychiatric, or medical condition that might affect the distribution of the radiopharmaceutical in the body or brain (as determined by Investigator)

Lab values

• Glucose level that would interfere with the FDG PET scan

Other

• Score on Mini-Mental Status examination of 20 or lower.
• Wheelchair-bound or bed-ridden, non-ambulatory.
• Pregnant or lactating women.
• Patient exceeds the weight limit of the table
• Claustrophobia that would prevent completion of imaging studies
• Any additional contraindications for MRI; Has metallic objects (e.g., pacemakers) in the body

• Clinical diagnosis of relapsing remitting MS or progressive MS who do not plan to start a medication during the study, or on stable disease modifying medication (interferon, glatiramer, dimethyl fumarate, teriflunomide).
• Age 18 years old to no upper limit
• Physically independent, ambulatory
• Women of childbearing potential will confirm a negative pregnancy test and must practice effective contraception during the period of pilot study. In addition, male subjects who have a partner of childbearing age should practice effective contraception.
• Participants must be able to complete study procedures in the greater Philadelphia area.