Filingeri Davide, Chaseling Georgia, Christogianni Aikaterini, Feka Kaltrina, Bianco Antonino, Davis Scott L, Jay Ollie
THERMOSENSELAB, Environmental Ergonomics Research Centre, Loughborough University, UK.
Thermal Ergonomics Laboratory, Faculty of Health Sciences, University of Sydney, NSW, Australia.
Temperature (Austin). 2020 May 24;8(1):21-29. doi: 10.1080/23328940.2020.1769007. eCollection 2021.
We investigated whether and how multiple sclerosis (MS) alters thresholds for perceiving increases and decreases in local skin temperature, as well as the sensitivity to progressively greater temperature stimuli, amongst heat-sensitive people with MS. Eleven MS patients (5 M/6 F; 51.1 ± 8.6 y, EDSS 5.7 ± 1.9) and 11 healthy controls (CTR; 7 M/4 F; 50.3 ± 9.0 y) performed warm and cold threshold tests on a hairy skin site, on both sides of the body. They also underwent a thermosensitivity test where they rated (visual analogue scale) perceived magnitude of 4 local skin stimuli (i.e. 22, 26, 34, 38°C). Individual thresholds and slopes of linear regression for thermosensitivity were z-transformed for each MS patient, and used to determine individual thermosensory abnormalities. When considering both threshold and thermosensitivity, six out of our 11 heat-sensitive patients (54.5%) exhibited skin thermosensory abnormalities. Those abnormalities varied amongst patients in terms of type (threshold vs. thermosensitivity), quality (warm vs. cold), location (left vs. right side of the body) and extent. Each of those six patients presented unique thermosensory profiles. While some patients experienced thermosensory loss in both thresholds and sensitivity and on both sides of the body, others experienced cold thermosensory loss on one side of the body only. The observed individual variability in thermosensory function among heat-sensitive MS patients highlight the need for a patient-centered approach to assessing thermosensory dysfunction and its potential implications for heat stress vulnerability in this patient group.
我们调查了多发性硬化症（MS）是否以及如何改变局部皮肤温度升高和降低的感知阈值，以及MS热敏感患者对逐渐增强的温度刺激的敏感性。11名MS患者（5名男性/6名女性；51.1±8.6岁，扩展残疾状态量表[EDSS]为5.7±1.9）和11名健康对照者（CTR；7名男性/4名女性；50.3±9.0岁）在身体两侧的一个有毛发的皮肤部位进行了温热和冷觉阈值测试。他们还接受了热敏感性测试，在此测试中他们对4种局部皮肤刺激（即22、26、34、38°C）的感知强度进行评分（视觉模拟量表）。对每位MS患者的热敏感性线性回归的个体阈值和斜率进行z变换，并用于确定个体热感觉异常。在考虑阈值和热敏感性时，我们11名热敏感患者中有6名（54.5%）表现出皮肤热感觉异常。这些异常在患者之间在类型（阈值与热敏感性）、性质（温热与寒冷）、位置（身体左侧与右侧）和程度方面存在差异。这6名患者中的每一位都呈现出独特的热感觉特征。虽然一些患者在阈值和敏感性方面以及身体两侧都出现了热感觉丧失，但另一些患者仅在身体一侧出现了冷觉热感觉丧失。在热敏感的MS患者中观察到的热感觉功能个体差异凸显了采用以患者为中心的方法来评估热感觉功能障碍及其对该患者群体热应激易感性的潜在影响的必要性。
