Cooling vest aids MS symptoms

High temperatures can exacerbate MS symptoms

Wearing a cooling vest can help multiple sclerosis (MS) patients with muscle strength, fatigue and balance.

A majority of MS patients report that their symptoms get worse in high temperatures, and that cooler temperatures help, at least temporarily.

It's a relatively easy treatment that brings an immediate benefit

Dr Jacques De Keyser

Researchers have developed vest and head-vest garments that attach to a box that pumps coolant fluid through tubes in the vest and cap.

But few studies have been done to determine how effective the vests are and how the cooling works within the body to reduce symptoms.

Researchers from the University Hospital in Groningen, Netherlands carried out tests on 10 patients whose symptoms were known to respond to temperature changes. Each wore the vests for an hour.

Half of the patients experienced active cooling, with the coolant set at 45 degrees.

The rest other half experienced 'sham' cooling, with the coolant set at 79 degrees, so the patients would feel a cool contact and would not know whether they were receiving the treatment or not.

A week later, the patients switched treatment.

Tests of the patients' fatigue level, balance and muscle strength were performed before the cooling and again three hours after the session.

The patients' temperatures were taken every 15 minutes.

Nitric oxide

Researchers also tested the blood of patients for white cell production of nitric oxide, a naturally occurring molecule, before and three hours after the cooling session.

The white cell nitric oxide production of 12 healthy volunteers was also tested as a comparison.

Compared to the healthy volunteers, white cells in MS patients produced more nitric oxide.

Researchers believe that nitric oxide plays a role in reducing the activity of damaged, or demyelinated, neurons in MS, and thus contributes to the development of symptoms.

Balance improved by an average of 20% for patients receiving active cooling, compared to those who received the sham cooling.

Muscle strength improved by an average of 10%.

The level of fatigue also improved significantly.

The level of nitric oxide decreased by 41% in patients receiving the active cooling.

After the sham cooling, patients' level of nitric oxide did not change.

The patients' temperatures did not drop during the cooling.

Exciting finding

Researcher Dr Jacques De Keyser said: "This is exciting, because it's a relatively easy treatment that brings an immediate benefit.

"Contrary to popular belief, the beneficial effects of the cooling garment can't be explained simply by a direct cooling of the central nervous system.

"These results raise the intriguing possibility that lowering of nitric oxide production may play an important role in this."

Dr De Keyser said more research was needed on the role nitric oxide plays in the symptoms of MS.

This could lead to efforts to mimic the effects of cooling through drugs or other means.

A spokesman for the MS Society said that the technology might benefit some patients in specific circumstances. But he said more research was required.

He said: "Anything which can help alleviate the symptoms of MS would be welcomed, but at this stage it is not a question of going out, getting a cooling vest and thinking it is going to have a long term effect on the course of your MS."

Dr Christine Jones, from the MS Research Trust, told BBC News Online: "Clearly many people with MS benefit from cooling suits and there is a body of evidence both scientific and anecdotal in support of heat sensitivity in MS.

"Indeed one of the early diagnostic tests was to put people in a hot bath and if their symptoms were exacerbated, MS was considered as an option!"  

The research is published in Neurology, the scientific journal of the American Academy of Neurology.