Lipoic Acid and Omega-3 Fatty Acids for Cognitive Impairment in Multiple Sclerosis

Inclusion Criteria:

• A definite diagnosis of multiple sclerosis (MS) with relapsing remitting or secondary progressive course

Age 18 to 65 years, inclusive
A score two or more standard deviations below the mean in one or more of the following cognitive tests: PASAT, COWAT, CVLT -II, Stroop
Expanded Disability Status Scale (EDSS) 0-7.5, inclusive
Suboptimal omega-3 levels (plasma docosahexaenoic acid [DHA] + eicosapentaenoic acid [EPA] < 5.0% of total plasma fatty acids)
If taking MS disease modifying medications, on stable dose for > 6 months preceding enrollment
Able to read and write English

Exclusion Criteria:

• Moderate to severe depression (Beck Depression Inventory score > 19)

Any significant uncontrolled medical problem including diabetes requiring insulin.
MS relapse within the 30 days before screening
Abnormalities of coagulation or current use of prescription anticoagulants or antiplatelet agents. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) are not excluded.
Fish intake of one 6 ounce serving > once a week less than 2 months prior to enrollment
Omega-3 fatty acid supplement intake (e.g. fish oil capsules, cod liver oil) less than 2 months prior to enrollment
Lipoic Acid supplementation less than 1 month prior to enrollment
Taking systemic corticosteroids, neuroleptics, antiparkinsonian agents, and/or narcotic analgesics. Low dose sinemet and dopamine agonist taken once a day for restless leg syndrome is not an exclusion.
Contraindications to MRI, including: subjects with intrathecal pumps, stimulators, pacemakers, aneurysm clips, non-removable hearing aids, or metal fragments in the eyes. Other exclusion criteria include the inability to lie flat on the back for 40 minutes at a time or a self-reported history of claustrophobia. Subjects with a history of hip replacement and those with well-documented, verifiable, MRI-safe cardiac stents will not be excluded from the study.
Epilepsy or history of seizures.
Pregnancy or women not using a reliable form of contraception
Corrected binocular visual acuity worse than 20/50 or more than one error on binocular color vision testing with the Ishihara Color plates or sustained nystagmus or diplopia on primary gaze
Inability to complete the neuropsychological test battery at the screening visit
Participation in another intervention study