Brief low-oxygen breathing to boost nerve plasticity and arm strength in MS
Investigating the Effects of Acute Intermittent Hypoxia on Neuroplasticity in Persons With Multiple Sclerosis
This will see if brief bouts of low-oxygen breathing (acute intermittent hypoxia) can quickly improve arm and hand strength and nerve signaling in people with relapsing-remitting MS who have arm weakness.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 22 (estimated) |
| Ages | 18 Years to 75 Years |
| Sex | All |
| Sponsor | Shirley Ryan AbilityLab Academic / other |
| Locations | 1 site (Chicago, Illinois) |
| Trial ID | NCT06390930 on ClinicalTrials.gov |
What this trial studies
Participants will undergo sessions of brief, controlled low-oxygen breathing (acute intermittent hypoxia) or a sham procedure while researchers measure arm and hand function before and after the intervention. The study records muscle responses and measures signals from the brain to arm muscles to examine corticospinal and spinal motoneuron excitability. Comparisons between the AIH and sham conditions will help determine whether AIH produces rapid changes in voluntary strength and neural excitability. The protocol is focused on short-term neural and functional changes rather than long-term rehabilitation outcomes.
Who should consider this trial
Good fit: People with relapsing-remitting MS who are relapse-free for ≥6 months, have measurable arm/hand weakness (reduced finger abduction strength or slowed 9-Hole Peg Test), an EDSS ≤7, and are on stable disease-modifying therapy would be the ideal candidates.
Not a fit: People with other causes of upper-limb impairment, uncontrolled blood pressure, significant lung disease, sleep apnea, epilepsy, high spasticity, cognitive impairment, or pregnancy are excluded and unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, AIH could offer a short, noninvasive way to quickly increase arm and hand strength and promote neural plasticity for people with MS.
How similar studies have performed: Related AIH protocols have produced rapid increases in voluntary muscle strength in people with incomplete spinal cord injury and small MS studies (reports of ~15–20% strength gains after a single session), but larger MS-specific evidence is limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Diagnosis of relapsing-remitting MS according to the McDonald criteria, over 5 years ago * Relapse free for at least 6 months * Expanded Disability Status Scale (EDSS) ≤7 * Index finger abduction strength \<5 according to Medical Research Council Scale, or 9-Hole Peg Test score \>20 seconds in at least one hand * Stable disease modifying therapies for at least 6 months * Individuals taking dalfampridine will be eligible if taking the same daily dose for at least 2 months prior to screening Exclusion Criteria: * Another diagnosis (e.g., peripheral neuropathies or orthopedic) affecting upper limb function * Mini-Mental State Examination (MMSE) score \<24 * Modified Ashworth Scale score \>3 on elbow joint * Uncontrolled hypertension or hypotension (outside 140/90 and 85/55 mmHg) * History of epilepsy, chronic obstructive pulmonary disease, or sleep apnea * Unstable medical conditions, ongoing upper limb therapy, or musculoskeletal pain * Pregnancy as confirmed by urine test
Where this trial is running
Chicago, Illinois
- Shirley Ryan AbilityLab — Chicago, Illinois, United States (Recruiting)
Study contacts
- Principal investigator: Milap Sandhu — Shirley Ryan Ability Lab
- Study coordinator: Rachel Kalvakota, OTD, OTR/L
- Email: rkalvakota@sralab.org
- Phone: 3122383947
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.