Table 1.

A summary of plant oil used in the treatment of MS clinical trial studies.

Plant Oil	Authors (Country)	Design of Study	Dosage	Duration of Study	Effects	Possible Mechanisms of Action and Principle Active Compounds
Pomegranate Seed Oil (PSO)	Petrou et al. [45] (Jerusalem)	Clinical trial with 30 MS patients, placebo pills containing soybean oil then additional PSO	Not mentioned	9 months	↑ cognitive functioning	Anti-oxidative action of PSO nanoemulsion and its main active ingredient punicic acid
Sesame seed oil (SSO)	Faraji et al. [62] (Iran)	Clinical trial, control treated with 30 μg/week.	30 μg/week of interferon beta-1a + 0.5 mL/kg/day of oral sesame oil	6 months	↓ Leukocyte proliferation and Nitric oxide ↓ IFN-γ and TNF-α	Anti- inflammatory and antioxidative action
Hemp seed oil and Evening primrose oil (HSO + EPO)	Majdinasab et al. [94] (Iran)	Clinical trial with 52 MS patients, with placebo Control		3 Months		Antioxidants and Inflammatory action.
	Rezapour-Firouzi et al., [96] (Iran)	Clinical trial, Placebo control of olive oil Each group has 20 patients.		6 Months	↑ Clinical improvements in expended disability status scale and relapse rate in MS Also, ↓ pro-inflammatory cytokines IL-17.	Antioxidant activity Inflammatory functions and cytokines production
	Rezapour-Firouzi et al., [97] (Iran)	Clinical trial, Placebo control of olive oil Each group has 23 patients.	1 g oral capsule containing EPO every 12 h for 3 months.	6 Months	↑ in red blood cells PUFAs and ↓ Phospholipase-A2 level.	Decrease Phospholipase-A2 level.
	Rezapour-Firouzi et al., [98] (Iran)	Clinical trial, Placebo control of olive oil Each group has 23 patients.	A combination of HSO and EPO with 9/1 ratio AT 18–21 g/day (6–7 g, three times daily)	6 Months	↑ extended disability status score.
	Rezapour-Firouzi et al., [87] (Iran)	Clinical trial, Placebo control of olive oil Each group has 20 patients.	A combination of HSO and EPO with 9/1 ratio AT 18–21 g/day (6–7 g, three times daily)	6 Months	↓ Pro-inflammatory cytokines of IFN-γ and IL-17 and ↑IL-4.	↓ Pro-inflammatory and ↑ in anti-inflammatory cytokines.
Coconut oil (CO)	Cuerda-Ballester et al., [109] (Spain)	Clinical trial of 27 MS patients, Placebo Control of 26 patients.	60 mL of extra virgin CO supplemented with EGCG.	4-month	↑ improvement in gait speed, quantitively balance and muscle strength.	The ketone bodies that may formed from EVCO metabolism balance.
	Platero et al., [115] (Spain)	Clinical trial of 24 MS patients and with Placebo Control of 27 patients.	60 mL of extra virgin coconut oil supplemented with epigallocatechin gallate (EGCG)at 800 mg.	4 Months	↓ in serum concentration of IL-6 and patients’ anxiety. ↑ Improvement in patients’ functionality.	The ketone bodies that may formed from CO metabolism balance.
Flaxseed oil (FSO)	Jelinek et al., [130] (Australia)	Surveyed study with MS patients through Web 2.0 platforms, including social media.	last 12 months.	A large cohort of 2469 people with MS disease	↓ Relapse rate was seen at large level (over 52%) for those MS patients who are taking FSO in univariate analysis. ↓ of disability.	anti-inflammatory and antioxidant action of PUFAs
Olive oil	Chatzikostopoulos et al. [146] (Greece)	Clinical trials With 30 MS patient 20 for intervention and 10 controls	Three tablespoons of EVOO/day	6 Months to one year	↑ Improvement visuospatial memory, processing speed and improvement in functions related to the frontal lobes, such as mental flexibility and adaptation to the environment when compared to control patients.	Neuroprotection action.
	Greta Wozniak et al. [150] (Cyprus)	Clinical trials with RRMS patients 10 patients for treatment and 5 patients as control.	50 mL of EVOO/day, Control patients did not take any oil.	2–4 months	↓ Reduction in fecal calprotectin levels after 2 and 4 months of administration, ↓ inflammation in the treated group.	↓ Inflammation by decreasing the fecal calprotectin due to the presence of t polyphenols in the oil.