Inclusion Criteria:  Male adults aged ≥18 years Diagnosed with ALD based on elevated VLCFA assay and pedigree analysis Clinical evidence of spinal cord involvement with EDSS score between 1 and 6.5  Exclusion Criteria:  Diagnosed with cerebral inflammatory disease or has a history of diagnosis with cerebral inflammatory disease Unstable, clinically significant neurologic (other than the disease being studied), psychiatric, cardiovascular, ophthalmologic, pulmonary, hepatic, renal, metabolic, gastrointestinal, urologic, immunologic, hematopoietic, or endocrine disease (other than adrenal insufficiency) or other abnormality, which may impact the ability to participate in the study or that may potentially confound the study results Participant who, in the opinion of the Investigator, has any other medical or psychological condition or social circumstances which would impair their ability to participate reliably in the assessments, or who may increase the risk to themselves or others by participating