Acute Intermittent Hypoxia Induces Motor and Cognitive Plasticity in Persons with Relapsing Remitting Multiple Sclerosis

Abstract

Background MS significantly impacts motor and cognitive function, yet therapies to effectively address these impairments remain limited. This study explores acute intermittent hypoxia (AIH) as a novel intervention for enhancing neuroplasticity and functional improvement in individuals with MS.

Objective To examine the efficacy of a single AIH session in improving spinal motor output and cognitive performance in MS.

Methods A randomized, blinded, placebo-controlled and crossover study was done in 10 individuals with relapsing-remitting MS. Participants underwent both AIH and sham AIH on separate days. AIH consisted of 15 brief exposures of low oxygen (9% O2) alternating with normoxia (i.e., room air). Sham AIH comprised of normoxic episodes. Pre- and post-intervention evaluations included isometric ankle torque to assess motor strength and standardized tests to evaluate cognitive function.

Results Participants showed a significant increase in both plantarflexion and dorsiflexion ankle torque (p < .05), alongside significant enhancements in cognitive processing speeds as measured by the Symbol Digit Modalities Test (p < .01) after AIH. No changes were observed in auditory/verbal memory, and no adverse events were reported.

Conclusion AIH presents a promising intervention for inducing neuroplasticity and improving rehabilitation outcomes in MS, suggesting the need for further exploration into its long-term impacts and mechanisms.

Competing Interest Statement

The authors have declared no competing interest.

Clinical Trial

NCT04280484

Funding Statement

This study was funded by a National Multiple Sclerosis Society grant.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

IRBs of Northwestern University and Hines Veteran Affairs gave ethical approval for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors.

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