title: Elevated body temperature is linked to fatigue in an Italian sample of relapsing-remitting multiple sclerosis patients.
abstract: Elevated body temperature was recently reported for the first time in patients with relapsing-remitting multiple sclerosis (RRMS) relative to healthy controls. In addition, warmer body temperature was associated with worse fatigue. These findings are highly novel, may indicate a novel pathophysiology for MS fatigue, and therefore warrant replication in a geographically separate sample. Here, we investigated body temperature and its association to fatigue in an Italian sample of 44 RRMS patients and 44 age- and sex-matched healthy controls. Consistent with our original report, we found elevated body temperature in the RRMS sample compared to healthy controls. Warmer body temperature was associated with worse fatigue, thereby supporting the notion of endogenous temperature elevations in patients with RRMS as a novel pathophysiological factor underlying fatigue. Our findings highlight a paradigm shift in our understanding of the effect of heat in RRMS, from exogenous (i.e., Uhthoff's phenomenon) to endogenous. Although randomized controlled trials of cooling treatments (i.e., aspirin, cooling garments) to reduce fatigue in RRMS have been successful, consideration of endogenously elevated body temperature as the underlying target will enhance our development of novel treatments.
authors.affiliation: Department of Neurology, Multiple Sclerosis Clinical Care and Research Center, Columbia University Medical Center, 630 W. 168th Street, PH 18-330, P&S Box 16, New York, NY, 10032, USA. VL2337@cumc.columbia.edu.
authors.forename: V M
authors.initials: VM
authors.lastname: Leavitt
authors.affiliation: Neuroimaging Research Unit, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: De Meo
authors.affiliation: Neuroimaging Research Unit, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Riccitelli
authors.affiliation: Neuroimaging Research Unit, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.|Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: M A
authors.initials: MA
authors.lastname: Rocca
authors.affiliation: Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Comi
authors.affiliation: Neuroimaging Research Unit, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.|Department of Neurology, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Filippi
authors.affiliation: Neuropsychology and Neuroscience Laboratory, Kessler Foundation Research Center, West Orange, NJ, USA.
authors.forename: J F
authors.initials: JF
authors.lastname: Sumowski
mesh_terms: D000328:Adult; D001831:Body Temperature / Q000502:physiology*; D005221:Fatigue / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications / Q000503:physiopathology*
keywords: Fatigue; Multiple sclerosis; Temperature