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

2011 ◽  
Vol 38 (1) ◽  
pp. 106-111 ◽  
Author(s):  
Luke F. Reynolds ◽  
Christine A. Short ◽  
David A. Westwood ◽  
Stephen S. Cheung
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Head And Neck ◽  
Thermal Sensation ◽  
Symptomatic Relief ◽  
Cooling Condition ◽  
Heat Sensitivity ◽  
Timed Up And Go ◽  
Multiple Sclerosis Patients ◽  
Neck Cooling

Abstract:Background: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.Methods: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.Results: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.Conclusions:Head and neck cooling may be an effective tool in increasing ambulatory capacity in individuals with MS and heat sensitivity.

Agreement analysis comparing iPad LCVA and Sloan testing in multiple sclerosis patients

2017 ◽  
Vol 24 (8) ◽  
pp. 1126-1130 ◽  
Author(s):  
Neda Sattarnezhad ◽  
Samantha Farrow ◽  
Dorlan Kimbrough ◽  
Bonnie Glanz ◽  
Brian Healy ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
T Test ◽  
Computerized Testing ◽  
Low Contrast ◽  
Significant Difference ◽  
Increased Sensitivity ◽  
The Right ◽  
Multiple Sclerosis Patients ◽  
Paired T Test

Background: Visual symptoms are common in multiple sclerosis (MS). Low-contrast visual acuity (LCVA) testing using Sloan charts has demonstrated increased sensitivity for visual deficits compared to high-contrast acuity testing. Computerized testing of visual acuity may facilitate use in the clinic setting. Objectives: To evaluate the agreement between an iPad-based and Sloan testing of LCVA in a cohort of MS patients. Methods: A total of 38 patients with relapsing-remitting MS were enrolled after providing informed written consent at Partners MS Center, Brigham and Women’s hospital. Monocular LCVA was measured using retroilluminated Sloan chart and iPad-based LogMAR chart. Number of correct letters and agreement between two measurements were assessed for each eye using Bland–Altman analysis and paired t-test. Results: For both eyes, there was no significant difference in number correct between the two measurements using a paired t-test, and there was high correlation between two measurements (oculus dextrus (OD) r = 0.89, p < 0.001; oculus sinister (OS) r = 0.78, p < 0.001). The limits of agreement were −7.9 to +8.5 letters for the right eye and −10.9 to +11.2 letters for the left eye. Conclusion: An iPad-based LCVA test shows good agreement with Sloan testing in MS patients.

scholarly journals Myelin status is associated with change in functional mobility following slope walking in people with multiple sclerosis

2018 ◽  
Vol 4 (2) ◽  
pp. 205521731877354 ◽  
Author(s):  
EM King ◽  
MJ Sabatier ◽  
M Hoque ◽  
TM Kesar ◽  
D Backus ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Water Content ◽  
Therapeutic Response ◽  
Functional Mobility ◽  
Functional Impairments ◽  
Timed Up And Go ◽  
Water Fraction ◽  
Walking Intervention ◽  
Myelin Water Fraction ◽  
Multiple Sclerosis Patients

Background The level of myelin disruption in multiple sclerosis patients may impact the capacity for training-induced neuroplasticity and the magnitude of therapeutic response to rehabilitation interventions. Downslope walking has been shown to increase functional mobility in individuals with multiple sclerosis, but it is unclear if myelin status influences therapeutic response. Objective The current study aimed to examine the relationship between baseline myelin status and change in functional mobility after a walking intervention. Methods The Timed Up and Go test was used to measure functional mobility before and after completion of a repeated, six-session slope walking intervention in 16 participants with relapsing–remitting multiple sclerosis. Multi-component T2 relaxation imaging was used to index myelin water fraction of overall water content in brain tissue compartments. Results Results demonstrated that the ratio of the myelin water fraction in lesion to normal-appearing white matter (myelin water fraction ratio) significantly predicted 31% of the variance in change in Timed Up and Go score after the downslope walking intervention, where less myelin disruption was associated with greater intervention response. Conclusions Myelin water content fraction ratio may offer a neural biomarker of myelin to identify potential responders to interventions targeting functional impairments in multiple sclerosis.

scholarly journals Microperimetry as a diagnostic tool for the detection of early, subclinical retinal damage and visual impairment in multiple sclerosis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Landon J. Rohowetz ◽  
Qui Vu ◽  
Lilit Ablabutyan ◽  
Sean M. Gratton ◽  
Nancy Kunjukunju ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Macular Thickness ◽  
Retinal Damage ◽  
Non Invasive ◽  
Control Subjects ◽  
Macular Sensitivity ◽  
History Of ◽  
Multiple Sclerosis Patients

Abstract Background A majority of multiple sclerosis patients experience visual impairment, often as the initial presenting symptom of the disease. While structural changes in the retinal nerve fiber layer and optic nerve have demonstrated correlations with brain atrophy in multiple sclerosis using magnetic resonance imaging, a non-invasive, cost-effective, and clinically efficacious modality to identify early damage and facilitate prompt therapeutic intervention to slow the progression of multiple sclerosis and its ocular manifestations, is still urgently needed. In this study, we sought to determine the role of macular sensitivity measured by microperimetry in the detection of subclinical multiple sclerosis-related retinal damage and visual dysfunction. Methods This cross-sectional observational case-control study involved population-based samples of multiple sclerosis patients and age-, race-, and gender-matched healthy control subjects. Among the key criteria for the multiple sclerosis patients were diagnosis by the McDonald criteria, visual acuity greater than 20/25, and no history of optic neuritis. Macular sensitivity and average macular thickness were measured in all subjects using microperimetry and spectral-domain optical coherence tomography, respectively. Pearson correlation coefficients were measured using bivariate correlations. Sample means, mean differences, and 95% confidence intervals were calculated using independent sample t-tests. Results Twenty-eight eyes from 14 MS patients and 18 eyes from 9 control subjects were included. Mean macular sensitivity of control subjects and multiple sclerosis patients in decibels was 18.2 ± 0.4 and 16.5 ± 0.4, respectively, corresponding to a mean difference of 1.7 (95% CI, 1.1–2.4; P < 0.001). Macular sensitivity was positively correlated with macular thickness in multiple sclerosis patients (r = 0.49, P = 0.01) but not control subjects (r = 0.15, P = 0.55). Conclusions Macular sensitivity as measured by microperimetry was decreased in multiple sclerosis patients with normal visual acuity and no history of optic neuritis. Furthermore, macular sensitivity demonstrated a positive correlation with macular thickness as measured by optical coherence tomography. As such, microperimetry may represent a non-invasive and efficient method to identify signs of subclinical visual dysfunction that correspond with early macular architectural changes characteristic of multiple sclerosis.

The effect of head and neck per-cooling on neuromuscular fatigue following exercise in the heat

2020 ◽  
Vol 45 (11) ◽  
pp. 1238-1246
Author(s):  
Ralph Joseph Frederick Hills Gordon ◽  
Neale Anthony Tillin ◽  
Christopher James Tyler
Keyword(s):  
Head And Neck ◽  
Thermal Sensation ◽  
Thermal Strain ◽  
Central Fatigue ◽  
Peak Oxygen Uptake ◽  
Voluntary Contraction ◽  
Peak Force ◽  
Peripheral Fatigue ◽  
Knee Extensors ◽  
Neck Cooling

The effect of localised head and neck per-cooling on central and peripheral fatigue during high thermal strain was investigated. Fourteen participants cycled for 60 min at 50% peak oxygen uptake on 3 occasions: thermoneutral control (CON; 18 °C), hot (HOT; 35 °C), and HOT with head and neck cooling (HOTcooling). Maximal voluntary force (MVF) and central activation ratio (CAR) of the knee extensors were measured every 30 s during a sustained maximal voluntary contraction (MVC). Triplet peak force was measured following cycling, before and after the MVC. Rectal temperatures were higher in HOTcooling (39.2 ± 0.6 °C) and HOT (39.3 ± 0.5 °C) than CON (38.1 ± 0.3 °C; P < 0.05). Head and neck thermal sensation was similar in HOTcooling (4.2 ± 1.4) and CON (4.4 ± 0.9; P > 0.05) but lower than HOT (5.9 ± 1.5; P < 0.05). MVF and CAR were lower in HOT than CON throughout the MVC (P < 0.05). MVF and CAR were also lower in HOTcooling than CON at 5, 60, and 120 s, but similar at 30 and 90 s into the MVC (P > 0.05). Furthermore, they were greater in HOTcooling than HOT at 30 s, whilst triplet peak force was preserved in HOT after MVC. These results provide evidence that central fatigue following exercise in the heat is partially attenuated with head and neck cooling, which may be at the expense of greater peripheral fatigue. Novelty Central fatigue was greatest during hyperthermia. Head and neck cooling partially attenuated the greater central fatigue in the heat. Per-cooling led to more voluntary force production and more peripheral fatigue.

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