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Purpose <p>To determine if reductions in whole-body thermal sensation (WBTS) with localised skin cooling mitigate heat-induced visual performance decrements in people with multiple sclerosis (MS), optic neuritis, and heat-sensitive visual symptoms, independent of core temperature increases.</p> Methods <p>Thirteen participants (7 relapsing–remitting MS (MS) patients with unilateral (left) optic neuritis and heat-sensitive visual symptoms; 6 controls) underwent visual performance testing on each eye at baseline and during passive heating (0.6℃ rise in gastrointestinal temperature (ΔT<sub>GI</sub>) via a hot water-perfused suit) under two counterbalanced crossover ordered conditions: 1) cold packs (0℃—CLD) or 2) hot packs (50℃—HOT) applied to the lower back. WBTS, visual symptoms, multifocal visual evoked potentials (mf-VEPs) amplitude/latency, and contrast sensitivity were assessed.</p> Results <p>ΔT<sub>GI</sub> was consistent across trials (<i>p</i> = 0.213; η<sub>p</sub><sup>2</sup> = 0.21). WBTS was only marginally lower (<i>p</i> = 0.017; η<sub>p</sub><sup>2</sup> = 0.42) in CLD than HOT for MS (CLD: 5.8 ± 0.9 a.u.; HOT: 6.4 ± 0.7 a.u.) and controls (CLD: 5.0 ± 0.9 a.u.; HOT: 5.9 ± 0.7 a.u.). Passive heating worsened (<i>p</i> = 0.027; η<sub>p</sub><sup>2</sup> = 0.59) visual symptoms in the affected eye similarly (<i>p</i> = 0.356; η<sub>p</sub><sup>2</sup> = 0.14) for HOT and CLD conditions. Heating reduced mf-VEPs amplitude in the left (affected) eye (<i>p</i> = 0.007; η<sub>p</sub><sup>2</sup> = 0.50) similarly (<i>p</i> = 0.332; η<sub>p</sub><sup>2</sup> = 0.09) across groups and conditions. For the unaffected (right) eye, reductions in mf-VEPs amplitude were greater in MS than controls (<i>p</i> = 0.031; η<sub>p</sub><sup>2</sup> = 0.36), with no difference between conditions (<i>p</i> = 0.339; η<sub>p</sub><sup>2</sup> = 0.08). mf-VEPs latency and contrast sensitivity were unaffected by heating.</p> Conclusion <p>Localised skin cooling during passive heating to a moderate core temperature produces only a modest reduction in WBTS and does not mitigate heat-induced visual performance decrements. The limited perceptual difference achieved suggests the localised skin cooling was insufficient to meaningfully isolate the effects of skin temperature from core temperature.</p>

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Toward isolating perceptual and physiological contributors to heat sensitivity in multiple sclerosis: insights from a new experimental model

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月11日

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  • Timothy English,
  • Joshua Barton,
  • Nicole Vargas,
  • Michael Barnett,
  • Ollie Jay

摘要

Purpose

To determine if reductions in whole-body thermal sensation (WBTS) with localised skin cooling mitigate heat-induced visual performance decrements in people with multiple sclerosis (MS), optic neuritis, and heat-sensitive visual symptoms, independent of core temperature increases.

Methods

Thirteen participants (7 relapsing–remitting MS (MS) patients with unilateral (left) optic neuritis and heat-sensitive visual symptoms; 6 controls) underwent visual performance testing on each eye at baseline and during passive heating (0.6℃ rise in gastrointestinal temperature (ΔTGI) via a hot water-perfused suit) under two counterbalanced crossover ordered conditions: 1) cold packs (0℃—CLD) or 2) hot packs (50℃—HOT) applied to the lower back. WBTS, visual symptoms, multifocal visual evoked potentials (mf-VEPs) amplitude/latency, and contrast sensitivity were assessed.

Results

ΔTGI was consistent across trials (p = 0.213; ηp2 = 0.21). WBTS was only marginally lower (p = 0.017; ηp2 = 0.42) in CLD than HOT for MS (CLD: 5.8 ± 0.9 a.u.; HOT: 6.4 ± 0.7 a.u.) and controls (CLD: 5.0 ± 0.9 a.u.; HOT: 5.9 ± 0.7 a.u.). Passive heating worsened (p = 0.027; ηp2 = 0.59) visual symptoms in the affected eye similarly (p = 0.356; ηp2 = 0.14) for HOT and CLD conditions. Heating reduced mf-VEPs amplitude in the left (affected) eye (p = 0.007; ηp2 = 0.50) similarly (p = 0.332; ηp2 = 0.09) across groups and conditions. For the unaffected (right) eye, reductions in mf-VEPs amplitude were greater in MS than controls (p = 0.031; ηp2 = 0.36), with no difference between conditions (p = 0.339; ηp2 = 0.08). mf-VEPs latency and contrast sensitivity were unaffected by heating.

Conclusion

Localised skin cooling during passive heating to a moderate core temperature produces only a modest reduction in WBTS and does not mitigate heat-induced visual performance decrements. The limited perceptual difference achieved suggests the localised skin cooling was insufficient to meaningfully isolate the effects of skin temperature from core temperature.