There are several medications available today for people with multiple sclerosis. But in the last few years, medical experts have been taking a closer look at a unique type of treatment known as cooling therapy.
Temperature Affects MS Symptoms?
According to the MS Cooling Foundation based in Monterey, California, cooling therapy involves the use of cooling devices that are designed to remove excess heat from the body. These devices come in the form of wet scarves tied around the neck, vests filled with frozen packets, and hoods and vests that attach to cooling pumps. The vests can cost about $200, whereas prices for the pump-connected hoods and vests can run upwards of $1000.1
How does cooling therapy work? The symptoms of multiple sclerosis occur when a fatty sheath that surrounds nerve fibers in the central nervous system known as myelin is stripped away, leaving the nerve endings vulnerable and unable to conduct electrical impulses with each other. Normally, the myelin insulation helps keep the signals between nerve fibers from shorting out as they travel to their destinations.
But when myelin is destroyed in MS, these nerve signals slow or stop completely, not only because current escapes through the damaged myelin, but also due to slight increases in body temperature.
In cooling therapy, the damaged nerve is cooled, and this in turn, slows down the speed of the electrical signal and lengthens its duration. The cooling also allows the signal to jump over damaged areas, and if the jump is successful, communication between the nerves can be restored.2
The Science Behind Cooling Therapy
Several medical studies have been published in the past few years to examine the effectiveness of cooling therapy for people with multiple sclerosis. Many of the studies have found only a limited effect, however.
Doctors at the University of Rochester looked at the effects of cooling in a group of 84 MS patients.3 The authors launched their study because previous research had not been convincing due to poor design, they wrote.
The investigators took measurements of the patient's physical function, as well as visual acuity and contrast sensitivity before and after the study. Two doses of cooling therapy for 1 hour with a liquid cooling garment were given to each patient. One week later, patients underwent the same tests before and after treatment, then were selected at random to use the cooling garment for 1 hour each day for a month, or to undergo observation only.
During this time, each patient answered questionnaires about fatigue, strength, and cognitive ability. They underwent a final cooling session at the end of the study. After 1 week of rest, the patients again underwent various tests of their functionality.
"High-dose cooling produced a small improvement" in each patient's functionality, the researchers wrote, "whereas low-dose cooling produced only a trend toward improvement, but the difference between conditions was not significant."
Regardless of the dose, motor and visual function improved in patients who underwent cooling therapy compared to those who did not. "When patients underwent acute cooling following a month of daily cooling, treatment effects were similar," they wrote. Patients also reported less fatigue during the month of daily cooling.
In conclusion, the study authors determined that cooling therapy's effect, while measurable, was modest.
More Research on Cooling
In an earlier study involving a smaller number of patients,4 doctors in Italy measured the effect of cooling therapy on visual and auditory function in a group of MS patients versus a group of healthy people.
The study subjects underwent various tests a total of 4 times over 2 days. The tests involved the use of electrodes to record the electrical activity of nerves.
At the end of the study, while cooling therapy had no effect on the electrical impulse activity of some nerves in the patients (visual evoked potential), it had a significant effect on the activity of other groups of nerves (brainstem auditory evoked potentials (BAEP) and middle latency auditory evoked potentials (MLAEP)).
Thus, the researchers concluded that cooling therapy might have a benefit for "selected patients only."
No Conclusive Evidence
There is still no conclusive evidence of the benefits of cooling for MS patients, according to the National Multiple Sclerosis Society.5 But the studies that have been published "are suggestive of positive outcomes from such kinds of therapies," the society writes on its website. The organization also advocates the use of more practical and cost-effective options for cooling therapy than a "cumbersome" cooling system. Those options include air conditioning, cool showers, cold drinks, and cooling garments.
1. Multiple Sclerosis Cooling Foundation. Questions and Answers. Available at: http://www.mscooling.org/questionsandanswers%20.html. Accessed February 18, 2005.
2. Multiple Sclerosis Cooling Foundation.
3. Schwid SR, Petrie MD, Murray R et al. A randomized controlled study of the acute and chronic effects of cooling therapy for MS. Neurology 2003 Jun 24;60(12):1955-60.
4. Romani A, Bergamaschi R, Versino M, Zilioli A, Callieco R, Cosi V. Circadian and hypothermia-induced effects on visual and auditory evoked potentials in multiple sclerosis. Clin Neurophysiol 2000 Sep;111(9):1602-6.
5. National Multiple Sclerosis Society. Research: Cooling Therapy. Available at: http://www.nationalmssociety.org/Research-2003June26.asp. Accessed February 18, 2005.
John Martin is a long-time health journalist and an editor for Priority Healthcare. His credits include coverage of health news for the website of Fox Television's The Health Network, and articles for the New York Post and other consumer and trade publications.
