Lipoic Acid for Progressive Multiple Sclerosis (MS)

This two-year study will determine if daily oral intake of lipoic acid will prove superior to
placebo in reducing injury to the brain and maintaining mobility in progressive MS. Mobility
will be assessed with the timed 25-foot walk test and 2-minute timed walk test as well as
fall counts. Neuroprotection will be measured by the extent of brain volume loss seen on MRI.

Inclusion Criteria:

- Diagnosis of progressive MS as defined by the study

- Able to give informed consent and to adhere to study procedures.

- Expanded Disability Status Scale (EDSS) 3.0 - 6.5: ambulatory for at least 20 meters
without rest and use of bilateral aids (canes, crutches, walker) or better.

Exclusion Criteria:

- A self-reported medical or neurological problem other than MS that is a cause of
progressive or fluctuating gait dysfunction

- Unable to undergo MRI

- Unable to follow directions in English as standardized scales are not all validated in
other languages.

- Current major disease or disorder other than MS (e.g., cancer, renal disease,
end-stage cardiopulmonary disease, post-traumatic stress disorder, etc.) that may
interfere with study procedures.

- Current Grade 1 or greater abnormal creatinine or glomerular filtration rate (GFR)
<55.

- Pregnant or breast-feeding.

- Insulin-dependent diabetes or diabetes not controlled on oral diabetes medications.

- Scheduled (every 3 months or more frequently) IV or oral steroids in the year prior to
enrolment.

- IV or oral steroids in the 60 days prior to enrolment.

- Use of LA in the prior 2 years exceeding the equivalent of 1200mg daily for 3 months.

- Participation in the pilot LA in SPMS trial.