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The Detection Research of Early Asymptomatic MS (DREAM) Study

The Detection Research of Early Asymptomatic MS (DREAM) study aims to discover the earliest immune system changes that ultimately cause Multiple Sclerosis (MS). The earlier MS can be detected, the less damage is done, so research on the early signs of MS is crucial. To find these early immune changes, we are bringing together a cohort of close relatives of people with Multiple Sclerosis (MS), such as parents, siblings, and children. While most family members will never have a problem related to MS, they are at a slightly higher risk than the general population. By participating in the DREAM cohort, family members can help us achieve the dream of stopping MS forever.

Who can Participate?

  • Close relatives (parent, sibling, child) of someone with MS
  • Age 13 or older
  • Participants may be invited to give other types of biologic specimens (e.g. stool, fat tissue, spinal fluid, tonsil aspirate) (optional)

What is Required?

  • All participants give a blood sample, an oral swab, complete a health history, and complete some surveys.
  • All participants are contacted periodically (up to four per year) on an ongoing basis for updated health information and to complete surveys
  • Participants may be invited to give follow-up blood donations (optional)
  • Participants may be invited to give other types of biologic specimens (like stool, fat tissue, spinal fluid) (optional)
  • Participants may be invited to have an MRI (optional)

Will I be Paid?

  • Participants will be paid $25 for each blood donation
  • There is no payment for oral swabs or for survey completion
  • If you donate another type of biologic specimen or get an MRI, you will be paid. The amount varies, depending on what type of test is being done.

What’s the Point?

We hope that studying people who are at higher risk for MS (but who do not have the disease) will provide the crucial insights needed to catch the disease when it is still asymptomatic. If we could find the disease that early, we believe it might be possible to prevent it entirely.

This type of research can’t be done alone. We need you to join the DREAM team and help us build a world free of MS.

Immunologically Isolated Syndrome in Early MS

One known risk factor for MS is infection with Epstein Barr virus. Although EBV is linked to MS, not much is known about how this happens – studies of EBV in blood and spinal fluid have not been very revealing. That may be because EBV preferentially infects cells within the tonsils and is much harder to detect in the rest of the body. Using a simple procedure, our team is collecting immune cells from tonsils from people newly diagnosed with MS and comparing these to cells obtained from healthy individuals. Similarly, other anatomically distinct body sites may be important for the development of MS, yet have never been studied in detail. Participants in our DREAM cohort of asymptomatic, at-risk individuals are contributing to immunologic studies, looking at potentially important immunologic niches, including the microbiome (gut and oral), adipose tissue, tonsil aspirates, and spinal fluid. individuals. We are also studying these tissues in early-stage MS patients.

Our big-picture goal is to be able to detect emerging MS before it has a chance to cause CNS damage. To do this, we will leverage our cohorts of pre-clinical and early-stage MS and combine their data with machine learning techniques to develop risk prediction models and identify currently healthy individuals who appear high risk for developing MS.


  • David Hafler, MD, Yale University - Single cell sequencing and deep immunology
  • Hemant Tagre, PhD, Yale University - Bioinformatics


Neurology Data and Biorepository (NDRB)

The NDRB establishes a biorepository that allows for collaborative investigation of the pathobiology of neurologic and immune diseases. Peripheral blood, oral and stool samples, and cerebrospinal fluid, along with extensive clinical data, are collected from diverse patients, including patients with all stages of MS who may be on or off treatment; patients with autoimmune encephalitis; patients with other suspected neuroinflammatory diseases; and controls subjects. Medical and demographic data are also collected to understand the biological factors uncovered by our mechanistic studies in the context of broader socioeconomic and environmental considerations.



MS and COVID-19 Vaccination

Our lab is working to ascertain how MS patients, specifically those on B-cell depletion, respond to standard and booster vaccinations against COVID-19.