Researchers randomized 36 people with mild to moderate multiple sclerosis to either usual care plus N-acetylcysteine (NAC) or usual care alone. The NAC group received 50 mg/kg of intravenous NAC once a week and 500 mg of oral NAC twice a day on the other days. Both groups had integrated PET-MRI scans and symptom questionnaires at baseline and after about four months. The findings were published in IBRO Neuroscience Reports.
Using resting-state BOLD fMRI, the team found significant connectivity shifts in the NAC group compared with controls in the inferior frontal region, cerebellum, and parts of the temporal and parietal lobes. FDG-PET showed corresponding increases in cerebral glucose metabolism in several of those areas, including the inferior frontal and inferior temporal gyri. Self-reported attention and cognition gains were correlated with these imaging changes, and fatigue, pain, cognition, and attention scores improved only in the NAC group.
MS affects roughly 2.8 million people worldwide, and an estimated 40% to 70% experience cognitive impairment tied to inflammation and oxidative stress, the authors note. Most approved therapies target inflammation rather than oxidative stress. The researchers call the trial an initial evaluation and say future work should clarify NAC dosing, duration, and timing.