We recently reported elevated body temperature and its association to fatigue in persons with relapsing-remitting multiple sclerosis (RRMS).
1The response by Mooney cites our article in support of a link between body temperature and environmental temperature that we actually did not investigate. In fact, we are currently most interested in investigating endogenous factors we believe to be related to body temperature elevations in persons with RRMS. Specifically, we are investigating a novel hypothesis of body temperature as a biomarker of inflammatory events in the brains of people with RRMS. Evidence reveals that only about 10% of new lesions are accompanied by a clinically evident exacerbation,
- Sumowski J.F.
- Leavitt V.M.
Body temperature is elevated and linked to fatigue in relapsing-remitting multiple sclerosis, even without heat exposure.
Arch Phys Med Rehabil. 2014; 95: 1298-1302
- Thorpe J.W.
- Kidd D.
- Moseley I.F.
- et al.
Serial gadolinium-enhanced MRI of the brain and spinal cord in early relapsing-remitting multiple sclerosis.
Neurology. 1996; 46: 373-378
3which means that a great amount of disease activity is taking place in the brains of people with RRMS in the absence of sensorimotor symptoms. The deleterious impact of this clinically silent inflammation is highlighted in an article by Zivadinov et al,
- Barkhof F.
- Scheltens P.
- Frequin S.T.
- et al.
Relapsing-remitting multiple sclerosis: sequential enhanced MR imaging vs clinical findings in determining disease activity.
AJR Am J Roentgenol. 1992; 159: 1041-1047
4who showed that regular corticosteroid use was much more effective than corticosteroid administered only during clinical relapses in preventing brain atrophy and physical disability over time in persons with RRMS. These findings suggest that clinically silent inflammation was being effectively treated by consistent administration of corticosteroids, which underscores the critical importance of developing an effective method for monitoring MS disease activity. Confirmation of our hypothesis holds the potential of identifying body temperature as a novel and easily obtained biomarker of clinically silent inflammation that would put disease monitoring in the hands of MS patients themselves for the very first time. This holds important and immediate implications for treatment, while also pointing to physiological mechanisms underlying MS fatigue.
- Zivadinov R.
- Rudick R.A.
- De Masi R.
- et al.
Effects of IV methylprednisolone on brain atrophy in relapsing-remitting MS.
Neurology. 2001; 57: 1239-1247
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- Body temperature is elevated and linked to fatigue in relapsing-remitting multiple sclerosis, even without heat exposure.Arch Phys Med Rehabil. 2014; 95: 1298-1302
- Serial gadolinium-enhanced MRI of the brain and spinal cord in early relapsing-remitting multiple sclerosis.Neurology. 1996; 46: 373-378
- Relapsing-remitting multiple sclerosis: sequential enhanced MR imaging vs clinical findings in determining disease activity.AJR Am J Roentgenol. 1992; 159: 1041-1047
- Effects of IV methylprednisolone on brain atrophy in relapsing-remitting MS.Neurology. 2001; 57: 1239-1247
Published online: January 08, 2015
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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- Climate Change: What Does It Mean for People With Multiple Sclerosis?Archives of Physical Medicine and RehabilitationVol. 96Issue 3
- PreviewRecently, Sumowski and Leavitt1 demonstrated that resting body temperature in people with relapsing-remitting multiple sclerosis (MS) is in fact elevated compared with healthy controls and is strongly associated with worsened fatigue. Their findings support the body of evidence that high ambient temperatures cause an increase in body temperature, and are known then to not only trigger worsened fatigue but also to exacerbate walking difficulty2 and falls risk.3