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Cooling gear can help with getting a handle on body temps. Not a solution, but a helpful aid. - Dave
Elevated brain temperature is associated with worse fatigue in multiple sclerosis patients
V.M. Leavitt1, A. Kangarlu2, C.S. Riley1, F. Liu3, J.F. Sumowski4
1Neurology, 2Psychiatry, Columbia University Medical Center, 3New York State Psychiatric Institute, New York, NY, 4Neuropsychology & Neuroscience, Kessler Foundation, West Orange, NJ, United States
Fatigue is a pervasive and debilitating symptom of multiple sclerosis (MS). Our current ability to effectively treat MS fatigue is hindered by a poor understanding of its pathophysiology and likely multiple underlying etiologies. We recently reported endogenously elevated body temperature and its association to worse fatigue in RRMS patients. Elevated brain temperature was also recently reported in 108 RRMS patients compared to 103 healthy controls (Hasan et al, 2015). In a preliminary study, we extend our temperature hypothesis of fatigue by investigating the association of elevated brain temperature and fatigue in MS.
Methods: 14 MS patients (11 female) served. Disease subtypes were 9 RRMS, 3 SPMS, 2 PPMS. Average age was 54.5 ± 9.8 years. Average body temperature was 36.8°C (98.2°F). Brain temperature was non-invasively measured with magnetic resonance spectroscopy (MRS) in a 3.0T Siemens Skyra scanner. MRS thermometry permits measurement of brain temperature with accuracy of ±0.1°C. The investigator who calculated brain temperature was blinded to all demographic/clinical data of all participants (i.e., age, phenotype, fatigue status). Fatigue was measured with the Fatigue Severity Scale (FSS).
Results: Average brain temperature was 37.4°C (99.32°F); average body temperature was 36.8°C (98.31°F). Higher brain temperature was associated with worse fatigue (r=.319). Higher body temperature was also associated with worse fatigue (r=.276). Also, the relationship between body temperature and fatigue was at least partially mediated by brain temperature.
Summary: Our current understanding and treatment of MS fatigue is limited, but our previous and current findings support elevated brain/body temperature as a candidate underlying mechanism for fatigue in MS. Cooling therapies to treat MS fatigue (i.e., aspirin, cooling garments) have shown efficacy in a small number of studies; however, these investigations did not consider endogenous temperature elevations as a target or explanation for treatment efficacy. Greater understanding/acknowledgment of elevated brain temperature and its consequences for patients with MS will support novel cooling treatments for fatigue. Brain temperature may be a sensitive outcome variable to consider for use in clinical trials.
Elevated brain temperature is associated with worse fatigue in multiple sclerosis patients
V.M. Leavitt1, A. Kangarlu2, C.S. Riley1, F. Liu3, J.F. Sumowski4
1Neurology, 2Psychiatry, Columbia University Medical Center, 3New York State Psychiatric Institute, New York, NY, 4Neuropsychology & Neuroscience, Kessler Foundation, West Orange, NJ, United States
Fatigue is a pervasive and debilitating symptom of multiple sclerosis (MS). Our current ability to effectively treat MS fatigue is hindered by a poor understanding of its pathophysiology and likely multiple underlying etiologies. We recently reported endogenously elevated body temperature and its association to worse fatigue in RRMS patients. Elevated brain temperature was also recently reported in 108 RRMS patients compared to 103 healthy controls (Hasan et al, 2015). In a preliminary study, we extend our temperature hypothesis of fatigue by investigating the association of elevated brain temperature and fatigue in MS.
Methods: 14 MS patients (11 female) served. Disease subtypes were 9 RRMS, 3 SPMS, 2 PPMS. Average age was 54.5 ± 9.8 years. Average body temperature was 36.8°C (98.2°F). Brain temperature was non-invasively measured with magnetic resonance spectroscopy (MRS) in a 3.0T Siemens Skyra scanner. MRS thermometry permits measurement of brain temperature with accuracy of ±0.1°C. The investigator who calculated brain temperature was blinded to all demographic/clinical data of all participants (i.e., age, phenotype, fatigue status). Fatigue was measured with the Fatigue Severity Scale (FSS).
Results: Average brain temperature was 37.4°C (99.32°F); average body temperature was 36.8°C (98.31°F). Higher brain temperature was associated with worse fatigue (r=.319). Higher body temperature was also associated with worse fatigue (r=.276). Also, the relationship between body temperature and fatigue was at least partially mediated by brain temperature.
Summary: Our current understanding and treatment of MS fatigue is limited, but our previous and current findings support elevated brain/body temperature as a candidate underlying mechanism for fatigue in MS. Cooling therapies to treat MS fatigue (i.e., aspirin, cooling garments) have shown efficacy in a small number of studies; however, these investigations did not consider endogenous temperature elevations as a target or explanation for treatment efficacy. Greater understanding/acknowledgment of elevated brain temperature and its consequences for patients with MS will support novel cooling treatments for fatigue. Brain temperature may be a sensitive outcome variable to consider for use in clinical trials.