INFLUENCE OF TEMPERATURE-CHANGES ON MULTIPLE-SCLEROSIS - CRITICAL-REVIEW OF MECHANISMS AND RESEARCH POTENTIAL

被引:152
作者
GUTHRIE, TC
NELSON, DA
机构
[1] New York, NY 10021, 767 Lexington Avenue
关键词
MULTIPLE SCLEROSIS; HEATING REACTION; INDUCED HYPERTHERMIA; EXACERBATIONS; NERVE CONDUCTION; HUMORAL; DEMYELINATION; OVERSHOOT;
D O I
10.1016/0022-510X(94)00248-M
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
In 1890, Uhthoff studied multiple sclerosis (MS) patients who developed amblyopia following exercise, a phenomenon later discovered to be secondary to elevated body temperature from muscular activity. Six decades later, the hot bath test and various other heating reactions (HR) began to be used diagnostically. They were essentially discontinued after 1983, being replaced by more specific and safer tests and procedures. Over 80% of MS patients develop a panoply of neurological signs during hyperthermia, 60% of which are ''new'' to that patient. The literature contains a number of unexplained paradoxical responses of MS patients during induced hyperthermia. These challenge the current hypothesis that, in MS, hyperthermia induces a heat-linked neuro-blockade of partially demyelinated axons. Some MS patients developed signs before temperature elevations occured; others showed clearing of signs while temperatures were elevated or were ascending. Several MS patients improved for about 3 hours after being tested, a rebound phenomenon known as ''overshoot.'' Conversely, other MS patients developed persistent neurological deficits after hyperthermia. The etiology of HR may be multifactorial. This includes heat itself, effects of serum calcium, blockade of ion channels, circulatory changes, heat shock proteins, and unidentified humoral substances. Research techniques are suggested to continue investigations into the enigma of HR, hopefully to widen knowledge of demyelination.
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页码:1 / 8
页数:8
相关论文
共 69 条
[1]   CRITICAL FUSION FREQUENCY IN MS DURING MILD INDUCED HYPERTHERMIA [J].
ACCORNERO, N ;
DEVITO, G ;
ROTUNNO, A ;
PERUGINO, U ;
MANFREDI, M .
ACTA NEUROLOGICA SCANDINAVICA, 1989, 79 (06) :510-514
[2]  
BERGER JR, 1982, JAMA-J AM MED ASSOC, V247, P979, DOI 10.1001/jama.1982.03320320019015
[3]   PERSISTENT NEUROLOGICAL DEFICIT PRECIPITATED BY HOT BATH TEST IN MULTIPLE-SCLEROSIS [J].
BERGER, JR ;
SHEREMATA, WA .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1983, 249 (13) :1751-1753
[4]  
BRICKNER R M, 1950, Res Publ Assoc Res Nerv Ment Dis, V28, P236
[5]   EXPRESSION OF HEAT-SHOCK GENES (HSP70) IN THE MAMMALIAN BRAIN - DISTINGUISHING CONSTITUTIVELY EXPRESSED AND HYPERTHERMIA-INDUCIBLE MESSENGER-RNA SPECIES [J].
BROWN, IR ;
RUSH, SJ .
JOURNAL OF NEUROSCIENCE RESEARCH, 1990, 25 (01) :14-19
[6]  
Cemalovic-Boko Z, 1981, Neurologija, V29, P33
[7]   FACTORS ASSOCIATED WITH A MALIGNANT OR BENIGN COURSE OF MULTIPLE-SCLEROSIS [J].
CLARK, VA ;
DETELS, R ;
VISSCHER, BR ;
VALDIVIEZO, NL ;
MALMGREN, RM ;
DUDLEY, JP .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1982, 248 (07) :856-860
[8]  
COLLINS RT, 1938, B NEUROL I NY, V7, P291
[9]  
COLVILLE PL, 1983, MULTIPLE SCLEROSIS P, P631
[10]  
Davis F A, 1966, J Mt Sinai Hosp N Y, V33, P280