The Effects of Induced Hyperthermia on Patients With Multiple Sclerosis

Nelson, Dewey A.; McDowell, Fletcher

doi:10.1136/jnnp.22.2.113

Cited by 77 publications

(32 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found adductor pollicis muscle function to be unaffected in patients with MS despite the high intramuscular temperature (approximately 37°C). 9 In many patients with MS, symptoms are exacerbated at higher temperatures, 22 a phenomenon attributed to a decreased capacity of demyelinated nerve fibers to conduct action potentials at higher core temperatures. 4 The present findings accord with the notion that the processes affected by an increase of temperature in MS patients are of a central origin, because muscle function was intact even following heating of the arm.…”

Section: Discussionmentioning

confidence: 99%

Contractile speed and fatigue of adductor pollicis muscle in multiple sclerosis

et al. 2001

View full text Add to dashboard Cite

The purpose of the study was to investigate differences in contractile speed, force, and fatigability of the adductor pollicis muscle between 12 patients with multiple sclerosis (MS) and 8 sedentary control subjects matched for age and gender. There were no differences between the patients with MS and control subjects with respect to the percentage of maximal muscle force that could be recruited during voluntary effort (95.5 ± 3.9% and 98.2 ± 2.0%, respectively, P = 0.10), the stimulation frequency/ force and force/velocity relationships, the rates of force development and relaxation, fatigue resistance, and the recovery rate of adductor pollicis muscle. However, previous results from the same group of MS patients showed that quadriceps femoris muscle force and resistance to fatigue were reduced. Therefore, our data support the clinical experience that, in patients with MS, lower limb muscle function is more or earlier affected than upper limb muscle function.

show abstract

Section: Discussionmentioning

confidence: 99%

Contractile speed and fatigue of adductor pollicis muscle in multiple sclerosis

et al. 2001

View full text Add to dashboard Cite

show abstract

“…However, Wilhelm Uhthoff's description of this phenomenon occurring after a hot bath or with exercise in MS patients with a history of optic neuritis has most commonly been cited as the landmark observation of the pathophysiological principle of temperature-induced conduction block in demyelinated axonal segments (Uhthoff's phenomenon) (77). It is estimated that 60 -80% of the MS population experience transient and temporary worsening of clinical signs and neurological symptoms as a result of elevated body temperature by immersion in warm water (41-43°C) or exposure to infrared heating lamps (27,46,50,51).…”

Section: Heat Sensitivity In Msmentioning

confidence: 99%

Thermoregulation in multiple sclerosis

Davis

Wilson

White

et al. 2010

Journal of Applied Physiology

147

View full text Add to dashboard Cite

Davis SL, Wilson TE, White AT, Frohman EM. Thermoregulation in multiple sclerosis. J Appl Physiol 109: 1531-1537. First published July 29, 2010 doi:10.1152/japplphysiol.00460.2010.-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. demyelination; core temperature; sweating; skin blood flow; fatigue MULTIPLE SCLEROSIS (MS) is a disabling progressive neurological disorder affecting ϳ400,000 individuals in the United States. The pathophysiology of MS results in a disruption or loss of axonal myelin in the central nervous system (CNS), leading to the formation of scar tissue (sclerosis). MS is thought to involve a number of autoimmune injury cascades that appear to be dependent on the interaction of complex epigenetic and environmental factors. Immune responses in individuals with MS are skewed toward a proinflammatory state, resulting in inflammation, demyelination, and ultimately loss of axons and disorganization of normal tissue architecture within the CNS (23). Demyelination is associated with corresponding changes in axonal physiology, including a loss of saltatory properties of electrical conduction, reduction in conduction velocity, and a predisposition to conduction block. These pathophysiological mechanisms underlie the myriad of symptoms (Table 1) in individuals with MS and are contingent on the neuroanatomic l...

show abstract

“…18,24,28 al. 4 demonstrated marked reduction in motor potenAlthough the effect of high temperature on the tial amplitudes and conduction block with fever in central nervous system has been well documented, a patient with demyelinating polyneuropathy; these especially in patients with multiple sclerosis, 5,20,23 its changes improved upon cooling. 4 In another report, effect on the peripheral nervous system has been…”

mentioning

confidence: 98%