We recently reported elevated body temperature and its association to fatigue in persons
with relapsing-remitting multiple sclerosis (RRMS).
1
The 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,
2
,
3
which 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,
4
who 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.To read this article in full you will need to make a payment
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References
- 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
Article info
Publication history
Published online: January 08, 2015
Footnotes
Disclosures: none.
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Copyright
© 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
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