Clinical applications of alpha-lipoic acid in the management of neurological disorders besides carpal tunnel syndrome.

the recent article by Di Geronimo et al was highly interesting1. The Authors have clearly demonstrated the efficacy of alpha-lipoic acid in the treatment of carpal tunnel syndrome. The findings of Di Geronimo et al are highly important as they further highlight the rapidly expanding role of alpha-lipoic acid in the management of other neurological conditions besides carpal tunnel syndrome. For instance, the DEKAN study has shown that daily administration of alpha-lipoic acid in patients with type II diabetes mellitus has a positive impact in decreasing the evolution and progression of autonomic neuropathy in cardiac tissue2. Similarly, alpha-lipoic acid administration results in accentuated frataxin production and thereby protects peripheral nervous tissue from the adverse effects of chemotherapeutic agents such as cisplatin3. Alpha-lipoic acid also attenuates the detrimental effects of oxidants on neuronic mitochondria and thereby decreases the impact of age on brain tissue4. Similarly, alpha-lipoic acid attenuates the formation and collection of nitrotyrosine in retinal cells and thereby decreases the visual deterioration in retinopathies such as diabetic retinopathy5. Alphalipoic acid may also have a beneficial role to play in the treatment of psychological conditions such as depression6. Alpha-lipoic acid may rarely be associated with major side effects such as insulin autoimmune syndrome. Despite this, alpha-lipoic acid promises to be a major new adjunct in the management of neurological diseases.