Table 4.

Effects of ALA in patients with multiple sclerosis (MS).

Patients (n)	Design	Treatment	Key Effects	References
Relapsing-remitting MS Age range: 18–50 n = 52	Clinical trial Randomized Double-blind Placebo-controlled	1200 mg/day ALA or placebo, orally Duration: 12 weeks	- Significant reduction in serum levels of INF-γ, ICAM-1 TGF-β and IL-4 - No significant changes in TNF-α, IL-6, EDSS and MMP-9 levels	[128]
Secondary progressive multiple sclerosis (SPMS) Age range: 40–70 n = 21	Clinical trial Randomized Double-blind Placebo-controlled Pilot study	1200 mg/day ALA or placebo, orally Duration: 2 years	- Significant improvements in walking performance in patients	[129]
Relapsing and remitting MS (RRMS), secondary progressive MS (SPMS) Age range: age ≥ 18 n = 57	Clinical trial Controlled	1200 mg racemic ALA once Duration: 48 h	- Increased cAMP at 2 and 4 h of ALA treatment in healthy and SPMS patients - Decrease cAMP in RRMS patients	[130]