Thermoregulation in multiple sclerosis

Multiple sclerosis (MS) is a progressive neurological disorder that disrupts axonal myelin in the central nervous system. Demyelination produces alterations in saltatory conduction, slowed conduction velocity, and a predisposition to conduction block. An estimated 60-80% of MS patients experience te...

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Bibliographic Details
Published in:	Journal of applied physiology (1985) 2010-11, Vol.109 (5), p.1531-1537
Main Authors:	DAVIS, Scott L, WILSON, Thad E, WHITE, Andrea T, FROHMAN, Elliot M
Format:	Article
Language:	eng
Subjects:	Autonomic Nervous System - physiopathology Biological and medical sciences Body temperature Body Temperature Regulation Central Nervous System - physiopathology Fatigue Fundamental and applied biological sciences. Psychology Heat Exhaustion - physiopathology Hemodynamics Highlighted Topic Humans Multiple sclerosis Multiple Sclerosis - physiopathology Nervous system Physiology Regional Blood Flow Skin - blood supply Stress Sweating Thermosensing
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Summary:	Multiple sclerosis (MS) is a progressive neurological disorder that disrupts axonal myelin in the central nervous system. Demyelination produces alterations in saltatory conduction, slowed conduction velocity, and a predisposition to conduction block. An estimated 60-80% of MS patients experience temporary worsening of clinical signs and neurological symptoms with heat exposure. Additionally, MS may produce impaired neural control of autonomic and endocrine functions. This review focuses on five main themes regarding the current understanding of thermoregulatory dysfunction in MS: 1) heat sensitivity; 2) central regulation of body temperature; 3) thermoregulatory effector responses; 4) heat-induced fatigue; and 5) countermeasures to improve or maintain function during thermal stress. Heat sensitivity in MS is related to the detrimental effects of increased temperature on action potential propagation in demyelinated axons, resulting in conduction slowing and/or block, which can be quantitatively characterized using precise measurements of ocular movements. MS lesions can also occur in areas of the brain responsible for the control and regulation of body temperature and thermoregulatory effector responses, resulting in impaired neural control of sudomotor pathways or neural-induced changes in eccrine sweat glands, as evidenced by observations of reduced sweating responses in MS patients. Fatigue during thermal stress is common in MS and results in decreased motor function and increased symptomatology likely due to impairments in central conduction. Although not comprehensive, some evidence exists concerning treatments (cooling, precooling, and pharmacological) for the MS patient to preserve function and decrease symptom worsening during heat stress.
ISSN:	8750-7587 1522-1601