Facial skin temperature in acute stroke patients with delirium - A pilot study

Jannik Stokholm,Abd Al Bari Omar Ahmed,Lars Kristian Hebsgaard Birkmose,Claudio Csillag,Troels Wesenberg Kjær,Thomas Christensen

doi:10.1016/j.jns.2021.120036

Abstract

Facial skin temperature depends strongly on blood flow in small blood vessels in the skin. These are regulated by the sympathetic part of the autonomic nervous system. Delirium may pathophysiologically be associated to changes in the sympathetic part of the autonomic nervous system. In this observational study, we evaluated the influence of various exogenous and endogenous covariables on the regional facial temperatures in acute stroke patients with and without delirium. Facial thermography (FT) was performed using an infrared digital camera. Screening for delirium was done using the Confusion Assessment Method (CAM). Sixty-four patients were enrolled. Eight patients developed delirium. Sex and body temperature were positively associated to facial skin temperature, and so was ambient temperature but to an overall lesser magnitude. Stroke severity, diabetes, infection, facial palsy, facial sensory deficit, and physical activity did not influence facial skin temperature. Overall, there was no association between facial temperature and the occurrence of delirium except in one facial region, the medial palpebral commissure.

Highlights

Skin temperature is strongly influenced by blood flow in small blood vessels of the skin which is regulated by the sympathetic part of the autonomic nervous system [1]
There was no association between facial temperature and the occurrence of delirium except in one facial region, the medial palpebral commissure
Sex and body temperature both had significant association to facial skin temperature and should both be considered in future research using infrared facial thermography

Summary

Introduction

Skin temperature is strongly influenced by blood flow in small blood vessels of the skin which is regulated by the sympathetic part of the autonomic nervous system [1]. The small blood vessels consist of arte rial and venous vasculature and constrict in response to an increased sympathetic stimulation [2]. Somatic stress results in a decreased skin blood flow and lower skin temperature. Acute stroke is often complicated by delirium [17] which patho physiologically may be associated with changes in the sympathetic part of the autonomic nervous system [18,19,20,21,22]. We hypothesized that changes in skin temperature may be linked to development of delirium in patients with acute stroke

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