WebMD - Cool News About MS

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Cool News About MS

Chilling Out Relieves Symptoms and Gives New Clues About the

Disease By Neil Osterweil

WebMD Medical News

Sept. 10, 2001 -- There's hot news about cool clothing for

people with multiple sclerosis (MS) -- and we're not talking

about the latest fashions. Researchers from the Netherlands

report that the symptom relief that many MS patients

experience when they wear specially designed cooling

garments may be due to a temporary decrease in the body's

production of the chemical nitric oxide.

The finding suggests that it may be possible to develop a

drug that mimics the effects of cooling and brings at least

temporary relief of symptoms to people with MS, write E.A.C.

Beenakker, MD, and colleagues in the Sept. 11 issue of the

journal Neurology.

" This is exciting, because it's a relatively easy treatment

that brings an immediate benefit, " says senior author

Jacques De Keyser, MD, PhD, from the University Hospital in

Groningen, Netherlands, in a written statement.

MS is a disease that attacks the outer insulation of nerve

fibers, which, when healthy, is supposed to help maintain

the speed of nerve impulses shuttling back and forth. About

80% of people with MS say their blurred vision, muscle

weakness, balance problems, and other symptoms get worse in

the summer or whenever they are exposed to high

temperatures. Researchers say that this occurs because heat

makes the weakened nerve impulses even weaker.

Now the Dutch investigators think they know why heat makes a

bad thing worse for people with MS, and why cooling the body

with icy baths, air conditioning, or special clothing

provides temporary relief. It appears that when these people

are overheated, the immune system releases nitric oxide,

which then might be blocking the transmission of important

nerve signals. This could make MS symptoms noticeably worse.

They arrived at this conclusion after studying the effects

of cooling at different temperatures in five men and five

women with MS. The participants were given a refrigerated

head-vest garment that could be set at different

temperatures. Half of the group were randomly assigned to

" active cooling " with vests cooled to 7 degrees Celsius

(44.6 degrees Fahrenheit) and half were assigned to " sham

cooling " with vests chilled to a more moderate 26 degrees

Celsius (78.8 degrees Fahrenheit).

The vest with the warmer setting still feels cold to the

touch because it is about 20 degrees lower than body

temperature. But its actual cooling effect on the body is

only minimal. This means that participants would not be able

to tell which group they had been assigned to, and the group

with the warmer vest could be used as a comparison.

The authors found that " in contrast to sham cooling, active

cooling resulted in a significant improvement of fatigue,

muscle strength in the lower limbs, and standing balance

with eyes closed. "

When they measured the concentration of nitric oxide (NO) in

the white blood cells of the patients and healthy

volunteers, they found that people with MS have higher

concentrations of NO than people without the disease. And

they also found that active cooling decreased the amount by

about 41%, whereas sham cooling did not affect the

concentration of NO.

" Contrary to popular belief, the beneficial effects of the

cooling garment can't be explained simply by direct cooling

of the central nervous system, " De Keyser says. " These

results raise the intriguing possibility that lowering of

nitric oxide productions may play an important role in

this. "

" Other studies have shown some benefit from cooling,

especially if you don't use the mechanical kind of vest [the

type used in the current study], " says LaRocca,

PhD, director of healthcare delivery and policy research at

the National Multiple Sclerosis Society in New York City,

who discussed the study with WebMD.

" What's new is this concept of the possible role of nitric

oxide in this process, " LaRocca says. " But it's unclear from

the study if that's really the explanation for the findings

or if there might be another explanation. Part of the

problem is that when you cool the body, you are affecting

almost every metabolic process. So yes, nitric oxide levels

might be affected, but if you evaluated all sorts of

physiological factors, you would find that they are also

affected. "

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