Sensitivity to heat in MS patients: a factor strongly influencing symptomology - an explorative survey

<p>Abstract</p> <p>Background</p> <p>Many individuals diagnosed with Multiple Sclerosis (MS) are sensitive to increased body temperature, which has been recognized as correlating with the symptom of fatigue. The need to explore this association has been highlighted. The aim of this study was to investigate the occurrence of heat sensitivity and its relations to disease course, disability, common MS-related symptoms and ongoing immunosuppressive treatments among individuals 65 years of age or younger diagnosed with MS.</p> <p>Methods</p> <p>A cross-sectional designed survey was undertaken. A questionnaire was sent to MS-patients with an Expanded Disability Status Score (EDSS) in the interval of 0-6.5 and who were between 20 and 65 years of age, living in an eastern region of Sweden (n = 334). Besides occurrence of heat sensitivity (Yes/No) and corresponding questions, the Fatigue Severity Scale (FSS), the MS-related symptom checklist and the Perceived Deficit Questionnaire (PDQ) were included. Data were analysed in relation to data level using Chi-square, Mann Whitney U-test, and Student's t-test. Pearson's and Spearman's correlations were calculated. In the logistic regression analyses (enter) dichotomized MS-symptoms were used as dependent variables, and EDSS, disease-course, time since onset, heat-sensitivity, age and sex (female/male) were independent variables. In the linear regression analyses, enter, mean FSS and summarized PDQ were entered as dependent variables and EDSS, disease-course, time since onset, heat sensitivity, age and sex (female/male) were independent variables.</p> <p>Results</p> <p>Of the responding patients (n = 256), 58% reported heat sensitivity. The regression analyses revealed heat sensitivity as a significant factor relating not only to fatigue (p < 0.001), but also to several other common MS symptoms such as pain (p < 0.001), concentration difficulties (p < 0.001), and urination urgency (p = 0.009).</p> <p>Conclusions</p> <p>Heat sensitivity in MS patients is a key symptom that is highly correlated with disabling symptoms such as fatigue, pain, concentration difficulty and urination urgency.</p

Ephaptic transmission between single nerve fibres in the spinal nerve roots of dystrophic mice.

1. Ephaptic transmission was observed between spontaneously active single nerve fibres in the spinal nerve roots of dystrophic mice. 2. In the five ephaptically interacting pairs of fibres studied in detail, the conduction velocities in the exciting fibres were < 1 m/sec and the conduction velocities in the excited fibres were 2-10 m/sec in the immediate vicinity of the ephapses at 26-28 degrees C. 3. Membrane current analysis suggested that conduction was continuous in the exciting fibres. In some cases conduction away from the ephapse in the excited fibre was saltatory in at least one and possibly in both directions of transmission. 4. It is concluded that in at least some cases the direction of ephaptic transmission is from bare axon to myelinated axon. 5. Transmission time across the ephapses, measured as the interval between peaks of inward membrane current in exciting and excited fibres, was less than or equal to microseconds-240 microseconds. 6. Ephaptic transmission is not necessarily contingent upon the direction of propagation of the impulse in the exciting fibre. 7. Ephaptic transmission between two fibres can remain stable at frequencies of at least 70 Hz. 8. There may be multiple sites of spontaneous ectopic excitation in single dystrophic mouse spinal root axons. An impulse traversing a site of ectopic excitation may incite a subsequent burst of impulses to arise from that site following a delay of more than 100 msec