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Antioxidant Lipoic Acid Reduces Brain Tissue Loss in Small Trial Involving People with Secondary-Progressive MS

July 11, 2017

SUMMARY:
  • In a study of 51 people with secondary progressive MS, the antioxidant lipoic acid was shown to reduce the rate of brain tissue loss compared to placebo. Walking improved, but not significantly.
  • Safety issues included stomach upset and two cases of kidney dysfunction.
  • The researchers are planning a larger, phase 2 clinical trial to further evaluate whether lipoic acid is a safe and effective treatment for progressive MS.
  • The team (Rebecca Spain, MD, MSPH, Oregon Health & Science University, and colleagues) report their findings in Neurology & Neuroinflammation, an open access journal (Published online June 28, 2017).
DETAILS:
Background: Antioxidants are natural or manmade substances found in many foods. In MS, the immune system damages and destroys myelin, the material that surrounds and protects nerve fibers in the brain and spinal cord. Nerve fibers themselves are damaged as well, which appears to drive long-term disability. “Free radicals” are normal by-products of bodily processes, and may cause tissue injury and turn on immune attacks in MS. Antioxidants block the action of free radicals. Controlled trials are underway to test the potential of several antioxidants for treating MS.
 
The Study: Drs. Rebecca Spain, Dennis Bourdette (Oregon Health & Science University) and colleagues randomly assigned 51 people with secondary progressive MS to receive lipoic acid (1,200 mg) or placebo by mouth daily for two years. The primary outcome was the change in percentage of brain volume as measured on MRI scans. Secondary measures included changes in disability and walking, quality of life, and safety.
 
The results showed that the rate of brain volume loss was reduced by 68% in the lipoic acid group compared to the placebo group. Brain volume loss is thought to be associated with MS disability; a reduction in the rate of brain volume loss may result in less disability. A test showed improvement in walking in the lipoic acid group, although this change did not reach statistical significance. The lipoic acid group also reported significantly fewer falls than the placebo group.
 
Adverse events in the lipoic acid group included stomach upset, along with one case of kidney failure and one case of kidney inflammation. The authors suggest close monitoring of kidney function in future studies of lipoic acid, and that caution should be exercised before recommending this dosage, since the kidney problems had not occurred in previous studies.
 
The team reports its findings in Neurology & Neuroinflammation, an open access journal (Published online June 28, 2017).
 
Next Steps: This team is planning a larger phase 2 study at multiple medical centers to further evaluate whether lipoic acid is a safe and effective treatment for progressive MS. This study is not yet recruiting participants.
 
Read more about diet and nutrition in MS

About Multiple Sclerosis

Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are leading to better understanding and moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.

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