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Randomized Controlled Trial
. 2018 Dec:41:169-174.
doi: 10.1016/j.ctim.2018.09.006. Epub 2018 Sep 22.

Effects of lipoic acid on walking performance, gait, and balance in secondary progressive multiple sclerosis

Bryan D Loy  1 , Brett W Fling  2 , Fay B Horak  3 , Dennis N Bourdette  4 , Rebecca I Spain  4
Affiliations
Randomized Controlled Trial

Effects of lipoic acid on walking performance, gait, and balance in secondary progressive multiple sclerosis

Bryan D Loy et al. Complement Ther Med. 2018 Dec.

Abstract

Background: Gait and balance impairment is common in secondary progressive multiple sclerosis (SPMS). Lipoic acid (LA), an over-the-counter antioxidant, is effective in MS animal models and may improve walking speed, but effects on mobility are unreported.

Objective: Examine the effects of 1200 mg daily oral dose of LA versus placebo (PLA) on gait and balance in a 2-year, randomized, double-blind pilot study.

Methods: 134 participants were screened for eligibility before assignment to LA (n = 28) or PLA (n = 26). Included here were, 21 participants with SPMS who took LA (N = 11) or PLA (N = 10) capsules for 2 years (enrolled May 2, 2011 - August 14, 2015) and completed all tasks without the use of an assistive device. Participants completed the Timed Up and Go (TUG) and quiet standing tasks every 6 months while wearing inertial sensors (APDM Opals) to quantify mobility.

Results: LA had a medium effect on time to complete TUG at 2 years (g = 0.51; 95% CI = -0.35, 1.38). In a subset of 18 participants with less disability (EDSS < 6, no use of ambulatory device), turning time was significantly shorter with LA (p = 0.048, Δ= 0.48 s). No differences in balance metrics were found between groups.

Conclusions: LA had an effect on walking performance in people with SPMS, particularly in those with lower baseline disability.

Trial registration: Lipoic Acid for Secondary Progressive Multiple Sclerosis https://clinicaltrials.gov/ct2/show/NCT01188811?term=spain+lipoic+acid&rank=1 NCT0118881.

Keywords: Antioxidant; Inertial sensors; Posture; Rehabilitation; Sway; Timed up and go.

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Conflict of interest statement

Conflict of Interest

B. Loy and B. Fling declare no conflicts of interest. OHSU and Dr. Horak have a significant financial interest in ADPM, a company that may have a commercial interest in the results of this research and technology. This potential institutional and individual conflict has been reviewed and managed by OHSU. D. Bourdette received travel funding from National Multiple Sclerosis Society, Consortium of MS Centers, and Paralyzed Veterans of America; serves on the editoral board for Neurology; holds patents for treatment of multiple sclerosis with cyclic peptide derivatives of cyclosporin and thyromimetic drugs for stimulating remyelination in multiple sclerosis; consulted for Magellan Health, Best Doctors, Inc.; and received research support from National MS Society. R. Spain received research support from Department of Veterans Affairs, Oregon Clinical and Translational Research Institute, VA ort land Health Care System, Oregon Health & Science University ,National MS Society ,Conrad Hilton Foundation ,Medical Research Foundation of Oregon, and Raceto Erase MS.

Figures

Figure 1.
Figure 1.
Effects of lipoic acid and placebo on time to complete the 7-meter timed up and go in the fast speed walking condition. Bars are standard deviations.
Figure 2.
Figure 2.
Change from baseline in time to complete the 7-meter timed up and go in the fast walking condition for each participant taking lipoic acid and place bo.A positive change indicates slowing from baseline and a negative change indicates improvement from baseline. The last two columns on the far right show the mean change (bars are standard deviations). Only participants with data at all visits are shown.
Figure 3.
Figure 3.
Effects of lipoic acid and placebo on time to complete the 7-meter timed up and go in the walking while subtracting condition (dual task). Bars are standard deviations.
Figure 4.
Figure 4.
Change from baseline in turning time during the 7-meter timed up and go in the fast walking condition for each participant taking lipoic acid and placebo. positive change indicates slowing from baseline and a negative change indicates improvement from baseline. Only participants who completed the 2 year study with EDSS < 6 are shown.
See this image and copyright information in PMC

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