Head Pre-Cooling Improves Symptoms of Heat-Sensitive Multiple Sclerosis Patients

Abstract

Damage to the central nervous system by Multiple Sclerosis (MS) leads to multiple symptoms, including weakness, ambulatory dysfunction, visual disturbances and fatigue. Heat can exacerbate the symptoms of MS whereas cooling can provide symptomatic relief. Since the head and neck areas are particularly sensitive to cold and cooling interventions, we investigated the effects of cooling the head and neck for 60 minutes on the symptoms of MS. We used a double blinded, placebo controlled, cross-over study design to evaluate the effects of head and neck cooling on six heat-sensitive, stable, ambulatory females with MS (Extended Disability Status Scale 2.5-6.5). To isolate the effects of perceived versus physiological cooling, a sham cooling condition was incorporated, where subjects perceived the sensation of being cooled without any actual physiological cooling. Participants visited the clinic three times for 60 minutes of true, sham, or no cooling using a custom head and neck cooling hood, followed by evaluation of ambulation, visual acuity, and muscle strength. Rectal and skin temperature, heart rate, and thermal sensation were measured throughout cooling and testing. Both the true and sham cooling elicited significant sensations of thermal cooling, but only the true cooling condition decreased core temperature by 0.37 °C (36.97 ± 0.21 to 36.60 ± 0.23 °C). True cooling improved performance in the six minute walk test and the timed up-and-go test but not visual acuity or hand grip strength. Head and neck cooling may be an effective tool in increasing ambulatory capacity in individuals with MS and heat sensitivity.