Clinical and immunological effects of cooling in multiple sclerosis

Multiple sclerosis (MS) patients often report that heat makes their symptoms worse. There is anecdotal evidence that the opposite, body cooling, may make MS symptoms better. The goal of this study was to determine whether core body temperature cooling compared to placebo treatment produced objective changes on the neurologic examination, and affected immune parameters, in MS patients. Eleven relapsing-remitting patients who reported heat sensitivity underwent cooling or sham cooling using a commercially available active liquid flow cooling garment. Clinical parameters of visual acuity, timed walk, muscle strength, and coordination, and immune parameters of cytokine production were examined one hour before and after treatment. Cooling produced a significant improvement in acuity, timed walk, and muscle strength compared to sham cooling. Cooling, but not sham cooling, also decreased cytokine production by MS peripheral blood cells. These results suggest that cooling can result in objective clinical improvements in several functional systems of heat-sensitive MS patients. In addition to a clinical effect, cooling may also have an immune effect on MS.