Grant: Project Grant

We have shown that up to 43% of people with Multiple Sclerosis (pwMS) have low oxygen (hypoxia) in the brain. It is important to determine if this hypoxia relates to more severe symptoms and disease progression. To measure hypoxia, we were the first to use a method that is safe and quick, where we shine light into the brain--frequency domain near-infrared spectroscopy (fdNIRS). It is accepted that hypoxia is bad for brain health and function. The level of hypoxia can be similar to those going to high altitude, where it causes symptoms often seen in MS including headaches, fatigue and difficulty concentrating. Hypoxia could also inhibit cell repair and increase progression. We will determine the levels of hypoxia in different types of MS and whether hypoxia relates to reduced brain function and quality of life. We will quantify brain network function using a NIRS brain mapping system, and with neurocognition tests. We will study how the hypoxia impacts progression using MRI, NIRS and questionnaires. We will use MRI and serum samples to study whether inflammation or reduced cerebral blood flow may be a cause of hypoxia. These tests will determine if pwMS who are hypoxic have more severe symptoms and poorer outcome. Our pilot data indicate that we have identified a large subset of pwMS who are different in their disease from the normoxic group, and so may benefit from individualized treatment. We will determine if short term oxygen treatment improves function and quality of life. There are many ways to deliver oxygen. We propose breathing oxygen delivered through a nasal tube because it is simple, low cost, and could be translated to large trials. This grant will characterize the impact of hypoxia on function, quality of life, and progression, and whether oxygen treatment will reduce the impact of the disease.