Article

OBJECTIVES: To investigate whether (1) resting body temperature is elevated in
patients with relapsing-remitting multiple sclerosis (RRMS) relative to healthy
individuals and patients with secondary progressive multiple sclerosis (SPMS),
and (2) warmer body temperature is linked to worse fatigue in patients with RRMS.
DESIGN: Cross-sectional study. SETTING: Climate-controlled laboratory (
approximately 22 degrees C) within a nonprofit medical rehabilitation research
center. PARTICIPANTS: Patients with RRMS (n=50), matched healthy controls (n=40),
and patients with SPMS (n=22). INTERVENTION: Not applicable. MAIN OUTCOME
MEASURES: Body temperature was measured with an aural infrared thermometer
(normative body temperature for this thermometer, 36.75 degrees C), and
differences were compared across patients with RRMS and SPMS and healthy persons.
Patients with RRMS completed measures of general fatigue (Fatigue Severity Scale
[FSS]), as well as physical and cognitive fatigue (Modified Fatigue Impact Scale
[MFIS]). RESULTS: There was a large effect of group (P<.001, etap(2)=.132)
whereby body temperature was higher in patients with RRMS (37.04 degrees +/-.27
degrees C) relative to healthy controls (36.83 degrees +/-.33 degrees C; P=.009)
and patients with SPMS (36.75 degrees +/-.39 degrees C; P=.001). Warmer body
temperature in patients with RRMS was associated with worse general fatigue (FSS;
rp=.315, P=.028) and physical fatigue (physical fatigue subscale of the MFIS;
rp=.318, P=.026), but not cognitive fatigue (cognitive fatigue subscale of the
MIFS; rp=-.017, P=.909). CONCLUSIONS: These are the first-ever demonstrations
that body temperature is elevated endogenously in patients with RRMS and linked
to worse fatigue. We discuss these findings in the context of failed treatments
for fatigue in RRMS, including several failed randomized controlled trials (RCTs)
of stimulants (modafinil). In contrast, our findings may help explain how RCTs of
cooling garments and antipyretics (aspirin) have effectively reduced MS fatigue,
and encourage further research on cooling/antipyretic treatments of fatigue in
RRMS.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS