title: Cold Blooded: Evaluating Brain Temperature by MRI During Surface Cooling of Human Subjects.
abstract: BACKGROUND
  Targeted temperature management (TTM) confers neurological and survival benefits for post-cardiac arrest patients with return of spontaneous circulation (ROSC) who remain comatose. Specialized equipment for induction of hypothermia is not available in the prehospital setting, and there are no reliable methods for emergency medical services personnel to initiate TTM. We hypothesized that the application of surface cooling elements to the neck will decrease brain temperature and act as initiators of TTM.
  
  
  METHODS
  Magnetic resonance (MR) spectroscopy was used to evaluate the effect of a carotid surface cooling element on brain temperature in healthy adults.
  
  
  RESULTS
  Six individuals completed this study. We measured a temperature drop of 0.69 ± 0.38 °C (95% CI) in the cortex of the brain following the application of the cooling element. Application of a room temperature element also caused a measurable decrease in brain temperature of 0.66 ± 0.41 °C (95% CI) which may be attributable to baroreceptor activation.
  
  
  CONCLUSIONS
  The application of surface cooling elements to the neck decreased brain temperature and may serve as a method to initiate TTM in the prehospital setting.
authors.affiliation: Department of Surgery, The Robert Larner, M.D. College of Medicine at The University of Vermont, Burlington, VT, USA.|Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Curran
authors.affiliation: Department of Surgery, The Robert Larner, M.D. College of Medicine at The University of Vermont, Burlington, VT, USA.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Wolfson
authors.affiliation: Department of Radiology, The Robert Larner, M.D. College of Medicine at The University of Vermont, Burlington, VT, USA.|MRI Center for Biomedical Imaging, The Robert Larner, M.D. College of Medicine at The University of Vermont, Burlington, VT, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Watts
authors.affiliation: Department of Surgery, The Robert Larner, M.D. College of Medicine at The University of Vermont, Burlington, VT, USA. kalev.freeman@uvm.edu.
authors.forename: Kalev
authors.initials: K
authors.lastname: Freeman
mesh_terms: D000328:Adult; D001831:Body Temperature / Q000502:physiology*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000502:physiology*; D003080:Cold Temperature; D017679:Cryotherapy / Q000379:methods*; D064368:Healthy Volunteers; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D009333:Neck / Q000502:physiology*; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy
keywords: Cardiac arrest; Cooling collar; Magnetic resonance spectroscopy; Surface cooling; Targeted temperature management; Therapeutic hypothermia