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Eye test peers into heat-related multiple sclerosis symptoms
March 24, 2008A bodysuit that heats or cools a patient, combined with painless measurements of eye movements, is providing multiple sclerosis researchers at UT Southwestern Medical Center with a new tool to study the mysterious link between body temperature and severity of MS symptoms.
The researchers studied an aspect of MS called Uhthoff's phenomenon, named for the German ophthalmologist who reported in 1889 that some people have temporary vision problems after exercise or in hot weather. This and other symptoms of MS, such as fatigue or problems with coordination, worsen in the heat for most people with the disease.
Although doctors and researchers have long known about Uhthoff's phenomenon, there has been no way to objectively measure its severity or how it is related to body temperature.
The UT Southwestern study, available online and appearing in the March 25 edition of the journal Neurology, demonstrated that as body temperature rises, the severity of an eye-movement disorder called INO, or internuclear ophthalmoparesis, also increases. When a person with INO looks rapidly from one object to another, one eye moves more slowly than the other. Normally, the eyes move at the same speed.
INO can serve as an easy-to-measure "canary in a coal mine," acting as a surrogate for other heat-related symptoms that are harder to measure, such as fatigue, mental confusion or bladder or bowel problems, said Dr. Elliot Frohman, professor of neurology and ophthalmology, director of the Multiple Sclerosis Program and Multiple Sclerosis Clinical Center at UT Southwestern and senior author of the study.
The researchers' tools were a whole-body suit, riddled with tubes for circulation of water, that can change body temperature; a pill-like thermometer that measures core body temperature after being swallowed; and an infrared camera that painlessly tracks eye movements.
The study, conducted at UT Southwestern, included eight patients with MS who have INO, eight with MS but not INO, and eight healthy control subjects. Warm water in the body garment raised each subject's normal temperature by one-half of a degree Celsius, and the cool water brought it down by one-half of a degree.
The subjects also wore a lightweight device, fitted on a headband, that used infrared light to track their eye movements as they followed a random sequence of blinking lights.
In the subjects with INO, increasing the body temperature worsened the differences between their two eyes' relative motion. Conversely, cooling the body made the eyes synchronize better.
Monitoring INO in a clinical setting could provide a sensitive test to determine a patient's susceptibility to other heat-related MS symptoms, as well as a way to monitor the effectiveness of treatments, Dr. Frohman said.
"With this new technique, we can objectively test new therapies that specifically treat a host of MS-related symptoms," said Dr. Frohman.
The next step in the research, Dr. Frohman said, is to use this system to measure the effectiveness of a drug that appears to relieve heat-induced symptoms in people with MS.
"We've shown that by this method we can model the principal mechanisms that cause certain symptoms to worsen in people with MS," he said.
Other UT Southwestern researchers involved in the study were lead author Dr. Scott Davis, assistant professor of neurology; Teresa Frohman, clinical research manager in neurology; Dr. Craig Crandall, associate professor of internal medicine; Douglas Mills, former research assistant; and Dr. Olaf Stüve, assistant professor of neurology. A researcher from the New Jersey Neuroscience Institute and a nurse from Presbyterian Hospital of Dallas also participated.
The work was supported by the National Multiple Sclerosis Society, Once Upon A Time -, the Cain/Denius Comprehensive Center for Mobility Research, the Sparrow Foundation, and the Hawn Foundation.
Visit http://www.utsouthwestern.org/neurosciences to learn more about
UT Southwestern's clinical services in neurosciences.
The University of Texas Southwestern Medical Center at Dallas
The UT Southwestern study, available online and appearing in the March 25 edition of the journal Neurology, demonstrated that as body temperature rises, the severity of an eye-movement disorder called INO, or internuclear ophthalmoparesis, also increases. When a person with INO looks rapidly from one object to another, one eye moves more slowly than the other. Normally, the eyes move at the same speed.
INO can serve as an easy-to-measure "canary in a coal mine," acting as a surrogate for other heat-related symptoms that are harder to measure, such as fatigue, mental confusion or bladder or bowel problems, said Dr. Elliot Frohman, professor of neurology and ophthalmology, director of the Multiple Sclerosis Program and Multiple Sclerosis Clinical Center at UT Southwestern and senior author of the study.
The researchers' tools were a whole-body suit, riddled with tubes for circulation of water, that can change body temperature; a pill-like thermometer that measures core body temperature after being swallowed; and an infrared camera that painlessly tracks eye movements.
The study, conducted at UT Southwestern, included eight patients with MS who have INO, eight with MS but not INO, and eight healthy control subjects. Warm water in the body garment raised each subject's normal temperature by one-half of a degree Celsius, and the cool water brought it down by one-half of a degree.
The subjects also wore a lightweight device, fitted on a headband, that used infrared light to track their eye movements as they followed a random sequence of blinking lights.
In the subjects with INO, increasing the body temperature worsened the differences between their two eyes' relative motion. Conversely, cooling the body made the eyes synchronize better.
Monitoring INO in a clinical setting could provide a sensitive test to determine a patient's susceptibility to other heat-related MS symptoms, as well as a way to monitor the effectiveness of treatments, Dr. Frohman said.
"With this new technique, we can objectively test new therapies that specifically treat a host of MS-related symptoms," said Dr. Frohman.
The next step in the research, Dr. Frohman said, is to use this system to measure the effectiveness of a drug that appears to relieve heat-induced symptoms in people with MS.
"We've shown that by this method we can model the principal mechanisms that cause certain symptoms to worsen in people with MS," he said.
Other UT Southwestern researchers involved in the study were lead author Dr. Scott Davis, assistant professor of neurology; Teresa Frohman, clinical research manager in neurology; Dr. Craig Crandall, associate professor of internal medicine; Douglas Mills, former research assistant; and Dr. Olaf Stüve, assistant professor of neurology. A researcher from the New Jersey Neuroscience Institute and a nurse from Presbyterian Hospital of Dallas also participated.
The work was supported by the National Multiple Sclerosis Society, Once Upon A Time -, the Cain/Denius Comprehensive Center for Mobility Research, the Sparrow Foundation, and the Hawn Foundation.
Visit http://www.utsouthwestern.org/neurosciences to learn more about
UT Southwestern's clinical services in neurosciences.
The University of Texas Southwestern Medical Center at Dallas
Multiple Sclerosis Current Events and Multiple Sclerosis News RSSMultiple health concerns surface as winter, vitamin D deficiences arrive
A string of recent discoveries about the multiple health benefits of vitamin D has renewed interest in this multi-purpose nutrient, increased awareness of the huge numbers of people who are deficient in it, spurred research and even led to an appreciation of it as "nature's antibiotic."
Factors from common human bacteria may trigger multiple sclerosis
Current research suggests that a common oral bacterium may exacerbate autoimmune disease. The related report by Nichols et al, "Unique Lipids from a Common Human Bacterium Represent a New Class of TLR2 Ligands Capable of Enhancing Autoimmunity," appears in the December 2009 issue of The American Journal of Pathology.
Drug studied as possible treatment for spinal injuries
Researchers have shown how an experimental drug might restore the function of nerves damaged in spinal cord injuries by preventing short circuits caused when tiny "potassium channels" in the fibers are exposed.
CSHL team solves structure of NMDA receptor unit that could be drug target for neurological diseases
A team of scientists at Cold Spring Harbor Laboratory (CSHL) reports on Thursday their success in solving the molecular structure of a key portion of a cellular receptor implicated in Alzheimer's, Parkinson's, and other serious illnesses.
Men leave: Separation and divorce far more common when the wife is the patient
A woman is six times more likely to be separated or divorced soon after a diagnosis of cancer or multiple sclerosis than if a man in the relationship is the patient, according to a study that examined the role gender played in so-called "partner abandonment." The study also found that the longer the marriage the more likely it would remain intact.
Neurologists Investigate Possible New Underlying Cause of MS
Neurologists at the University at Buffalo are beginning a research study that could overturn the prevailing wisdom on the cause of multiple sclerosis (MS).
Scientists demonstrate link between genetic defect and brain changes in schizophrenia
Researchers at the University of North Carolina at Chapel Hill School of Medicine have found that the 22q11 gene deletion - a mutation that confers the highest known genetic risk for schizophrenia - is associated with changes in the development of the brain that ultimately affect how its circuit elements are assembled.
Gentle touch may aid multiple sclerosis patients
While gripping, lifting or manipulating an object such as drinking from a cup or placing a book on a shelf is usually easy for most, it can be challenging for those with neurological diseases such as multiple sclerosis or Parkinson's, or for people who had a stroke. For them, the tight gripping can cause fatigue, making everyday tasks difficult.
Urate in blood and spinal fluid may predict slower decline in patients with Parkinson's disease
Higher concentration of urate (an antioxidant) in the blood and spinal fluid of patients with early Parkinson's disease is associated with slower rates of clinical decline.
Oxidized form of a common vitamin may bring relief for ulcerative colitis
New research published in the Journal of Leukocyte Biology finds retinoic acid may alleviate ulcerative colitis and similar irritable bowel diseases.
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