Temperature Sensation Changes in Multiple Sclerosis
Yes, Multiple Sclerosis (MS) can cause significant changes in temperature sensation, with 60-80% of MS patients experiencing temperature sensitivity where neurological symptoms worsen with changes in body temperature.
Mechanisms of Temperature Sensitivity in MS
- Temperature sensitivity in MS primarily results from temperature-dependent slowing or blocking of neural conduction within the central nervous system due to demyelination 1
- Even small increases in body temperature (as little as ~0.4°C) can significantly decrease cold thermosensitivity by approximately 10% in MS patients 2
- Demyelinated axons are particularly vulnerable to temperature changes, as increased temperature can lead to conduction slowing and/or complete conduction block 3
- The threshold for conduction block is temperature-dependent and likely proportional to the degree of demyelination in affected neural pathways 4
Clinical Manifestations of Temperature Sensitivity
- Cold thermosensitivity is more commonly affected than warm thermosensitivity, with MS patients showing decreased sensitivity across a wider temperature range than healthy individuals 2
- Temperature sensitivity affects both cold and warm perception pathways, though effects on myelinated cold-sensitive pathways are more pronounced 2
- Approximately 93% of MS patients report marked sensitivity to heating, with 90% experiencing worsening of neurological symptoms or general feeling in a hot bath 4
- About half of MS patients report improvement in symptoms when exposed to cold temperatures 4
Factors Associated with Temperature Sensitivity
- MS patients with temperature sensitivity show significantly greater disability, depression, fatigue, and physical and psychological functional effects compared to those without temperature sensitivity 5
- Self-reported difficulty using hands in everyday tasks is significantly associated with increased odds of temperature sensitivity 5
- Lack of disease-modifying therapy (DMT) use is strongly associated with increased temperature sensitivity 5
- Temperature sensitivity is not strongly correlated with objective measurements of autonomic or corticospinal integrity, suggesting other mechanisms are involved 5
Pathophysiological Impact
- Temperature-induced changes can trigger bioenergetic failure with demand cerebral ischemia and significant mismatch in energy supply and demand to the brain 6
- MS lesions can occur in areas of the brain responsible for temperature regulation, potentially impairing neural control of thermoregulatory pathways 3
- Structural CNS damage progresses at different rates across various clinical phenotypes of MS, affecting temperature sensation differently among patients 7
Clinical Implications
- Temperature sensitivity can serve as a clinical marker for MS progression and should be monitored during patient evaluation 1
- Recognizing temperature sensitivity is important as it may indicate a noticeable part of neurological deficit that could potentially be reversible through appropriate interventions 4
- Advanced MRI techniques can help characterize the extent of structural changes in white and grey matter that may contribute to temperature sensation abnormalities 7
Management Considerations
- Cooling strategies may help preserve function and decrease symptom worsening during heat stress in temperature-sensitive MS patients 3
- Disease-modifying therapies may help reduce temperature sensitivity, as lack of DMT use is associated with increased odds of temperature sensitivity 5
- Patients should be educated about avoiding situations that increase core body temperature, such as hot baths, saunas, or excessive exercise in warm environments 4
Understanding temperature sensation changes in MS is crucial for proper patient management and may provide insights into underlying pathophysiological mechanisms of the disease.