Thermal Modulation in Multiple Sclerosis Management

Thermal modulation encompasses strategies that alter body or environmental temperature to mitigate symptom exacerbation in people with multiple sclerosis (MS). Heat sensitivity affects up to 80 per cent of individuals with MS, often precipitating transient worsening of fatigue, motor function and cognitive processing. Conversely, cold exposure may confer relief by stabilising nerve conduction and reducing inflammation, although excessive cooling can trigger discomfort or rigidity. The thermoregulatory challenges in MS arise from demyelinated axons’ impaired capacity to conduct action potentials when exposed to modest rises in core or skin temperature. Interventions range from simple behavioural adaptations, such as air conditioning and structured rest periods, to active and passive cooling devices that redistribute heat away from vulnerable tissues. Recent advances have explored wearable and medical-grade cooling systems, cryotherapy protocols and targeted cooling of extremities and the scalp. These approaches aim not only to restore functional performance in daily activities but also to inform personalised rehabilitation and self-management plans. The global significance of thermal modulation lies in its potential to enhance quality of life, reduce reliance on pharmacotherapy for symptomatic relief and guide ergonomic adjustments in home and workplace settings.

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Thermal Modulation in Multiple Sclerosis Management publication trend

The graph below shows the total number of articles in thermal modulation in multiple sclerosis management across all publications each year (not limited to Nature Index journals).

Technical terms

Thermal modulation: The deliberate alteration of body or environmental temperature to influence physiological or symptomatic outcomes.

Uhthoff’s phenomenon: Temporary worsening of neurological symptoms in MS triggered by small elevations in body temperature.

Thermosensitivity: The degree to which an individual’s symptoms respond adversely to changes in ambient or core temperature.

Whole-body cryotherapy: A therapeutic approach involving brief exposure to extremely low air temperatures to achieve rapid cooling of the entire body.

References

1. Sensitivity to heat in MS patients: a factor strongly influencing symptomology - an explorative survey. BMC Neurology (2011).
2. Heat and cold sensitivity in multiple sclerosis: A patient-centred perspective on triggers, symptoms, and thermal resilience practices. Multiple Sclerosis and Related Disorders (2022).
3. Body temperatures, thermal comfort, and neuropsychological responses to air temperatures ranging between 12°C and 39°C in people with Multiple Sclerosis. Physiology & Behavior (2023).
4. Diuretic‐sensitive electroneutral Na+ movement and temperature effects on central axons. The Journal of Physiology (2017).
5. Positive Effect of a Cooling Cap on Functional Performance in Thermosensitive People with Multiple Sclerosis: A Randomized Controlled Trial. Acta Neurologica Scandinavica (2024).