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Effects of Acute Intermittent Hypoxia on Neuroplasticity in MS
NCT06390930 · Shirley Ryan AbilityLab
In plain English
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Official title
Investigating the Effects of Acute Intermittent Hypoxia on Neuroplasticity in Persons With Multiple Sclerosis
About this study
While AIH has shown potential in enhancing neuroplasticity in people with spinal cord injury (SCI), it has yet to be studied extensively in MS. Preliminary research in the MS population demonstrates that a single session of AIH enhances motor output, increasing voluntary muscle strength by as much as 15-20% within 60 minutes. This study will explore potential mechanisms of AIH in MS using measurements of arm function, as well as examination of corticospinal and spinal motoneuron excitability.
Over the past decade, studies have found that brief episodes of modest oxygen reduction (termed AIH) can rapidly enhance neural plasticity in persons with incomplete SCI. AIH activates the serotonergic pathway, leading to increased activity of serotonin receptors and the synthesis of plasticity-related proteins. This plasticity is manifested by a rapid increase in voluntary muscle strength, emerging within 60-90 minutes, in both lower- and upper-limb muscles. The actions of AIH appear to be biologically linked to systems designed to preserve breathing systems that are impaired by damage to the central nervous system (CNS).
Eligibility criteria
Inclusion Criteria:
* Diagnosis of relapsing-remitting MS according to the McDonald criteria, over 5 years ago
* Relapse free for at least 6 months
* Expanded Disability Status Scale (EDSS) ≤7
* Index finger abduction strength \<5 according to Medical Research Council Scale, or 9-Hole Peg Test score \>20 seconds in at least one hand
* Stable disease modifying therapies for at least 6 months
* Individuals taking dalfampridine will be eligible if taking the same daily dose for at least 2 months prior to screening
Exclusion Criteria:
* Another diagnosis (e.g., peripheral neuropathies or orthopedic) affecting upper limb function
* Mini-Mental State Examination (MMSE) score \<24
* Modified Ashworth Scale score \>3 on elbow joint
* Uncontrolled hypertension or hypotension (outside 140/90 and 85/55 mmHg)
* History of epilepsy, chronic obstructive pulmonary disease, or sleep apnea
* Unstable medical conditions, ongoing upper limb therapy, or musculoskeletal pain
* Pregnancy as confirmed by urine test
Study design
Enrollment target: 22 participants
Allocation: randomized
Masking: double
Age groups: adult, older_adult
Timeline
Starts: 2025-02-01
Estimated completion: 2027-07
Last updated: 2026-02-23
Interventions
Other: Acute Intermittent HypoxiaOther: Sham Acute Intermittent Hypoxia
Primary outcomes
- • Motor Evoked Potentials (MEPs) in First Dorsal Interosseous (FDI) (Immediately before, immediately after, and 60 minutes after the intervention.)
- • Changes in Spinal Reflex Threshold (Immediately before the intervention and immediately after the intervention.)
- • Threshold For Detecting Passive Joint Movement (Immediately before the intervention and immediately after the intervention.)
Sponsor
Shirley Ryan AbilityLab · other
With: National Multiple Sclerosis Society
Contacts & investigators
ContactRachel Kalvakota, OTD, OTR/L · contact · rkalvakota@sralab.org · 3122383947
InvestigatorMilap Sandhu · principal_investigator, Shirley Ryan Ability Lab
All locations (1)
Shirley Ryan AbilityLabRecruiting
Chicago, Illinois, United States