OBJECTIVE: Patients with multiple sclerosis (MS) have more clinical exacerbations and T2 lesion activity during warmer weather. The current study is the first to investigate whether outdoor temperature is related to cognitive status across patients with MS (cross-sectional analysis), and whether cognitive status fluctuates with changes in outdoor temperature within patients with MS (longitudinal analysis).
METHODS: For the cross-sectional analysis, 40 patients with MS and 40 healthy control (HC) subjects were recruited throughout the calendar year. Cognitive status (processing speed, memory) and outdoor temperature were recorded for the day of testing. We calculated partial correlations between cognitive status and temperature for patients with MS and HCs, controlling for demographic and disease variables. For the longitudinal analysis, cognitive status and outdoor temperature were recorded at baseline and 6-month follow-up in a separate sample of 45 patients with MS. We calculated the partial correlation between temperature and cognitive status at follow-up, controlling for baseline temperature and cognitive status (i.e., whether temperature changes are related to cognitive changes within patients with MS).
RESULTS: Cross-sectionally, warmer temperature was related to worse cognitive status in patients with MS (r(p) = -0.45, p = 0.006), not in HCs (r(p) = 0.00, p = 0.984). Longitudinally, increased outdoor temperature from baseline to follow-up was related to a decline in cognitive status within patients with MS (r(p) = -0.39, p = 0.010).
CONCLUSIONS: Cognitive status in patients with MS is worse on warmer days, consistent with a previously established link between heat and lesion activity. Our findings have implications for clinical trial planning, treatment, and lifestyle decisions. We discuss cognitive status as a potential marker of quiescent exacerbations
Temperature has been shown to influence some signs of multiple sclerosis previously. Uhthoff’s phenomenon is the worsening of neurologic symptoms in multiple sclerosis (MS) and other neurological, demyelinating conditions when the body gets overheated from hot weather, exercise, fever, or saunas and hot tubs. It is possibly due to the effect of increased temperature on nerve conduction. With an increased body temperature, nerve impulses are either blocked or slowed down in a damaged nerve but once the body temperature is normalized, signs and symptoms may disappear or improve. Therefore it may not be surprising that heat can affect MS behaviours of cognitive function similar to Uhthoffs phenomenon.