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Voluntary Cooling during Exercise Is Augmented in People with Multiple Sclerosis Who Experience Heat Sensitivity.

INTRODUCTION
We tested the hypothesis that people with Multiple Sclerosis (MS) who experience heat sensitivity voluntarily engage in cool-seeking behavior during exercise to a greater extent than healthy controls.


METHODS
In a 27.0 ± 0.2 °C, 41 ± 2% RH environment, 7 participants with relapsing-remitting MS who exhibited heat sensitivity and 7 healthy controls completed two randomized trials cycling for 40 min (EX) at 3.5 W⋅kg-1 metabolic heat production, followed by 30 min recovery (REC). In one trial, participants were restricted from engaging in cooling (CON). In the other, participants voluntarily pressed a button to receive 2 min of ~2 °C water perfusing a top (COOL). Mean skin and core temperatures and mean skin wettedness were recorded continuously. Total time in cooling provided an index of cool-seeking behavior. Ratings of perceived exertion (RPE), total symptom scores (TSS, MS only) and subjective fatigue (MS only) were recorded every 10 min.


RESULTS
Core temperature (+0.5 ± 0.1 °C) and skin wettedness (+0.53 ± 0.02 a.u.) increased but were not different between groups or trials at end-exercise (P = 0.196) or end-recovery (P = 0.342). Mean skin temperature was reduced in COOL compared to CON at end-exercise (P ≤ 0.002), with no differences between groups (P ≥ 0.532). MS spent more total time in cooling during EX (MS: 13 ± 3 min; Healthy: 7 ± 4 min, P < 0.001) but not REC (MS: 2 ± 1 min; Healthy: 0 ± 1 min, P = 0.496). RPE was greater at end-exercise in MS (P = 0.001). TSS increased during exercise (P = 0.005) but was not different between trials (P = 0.321), while subjective fatigue was not attenuated in the cooling trial (P = 0.065).


CONCLUSION
Voluntary cooling is augmented in MS but does not consistently mitigate perceptions of heat related symptoms or subjective fatigue.