Abstract
This chapter is focused on the disruption of thermoregulation in individuals with spinal cord injuries. Thermoregulation is a vital process that maintains the body’s core temperature within a narrow range regardless of changes in external temperature. The hypothalamus is responsible for maintaining this balance by integrating information from various temperature sensors in the body. However, spinal cord injuries can impair this function by reducing afferent input to the thermoregulatory brain areas and disrupting vasomotor control and sweating capacity below the level of injury. This leads to fluctuations in body temperature, hyperthermia, and hypothermia, especially in individuals with injuries above T6. The chapter explores the mechanisms behind thermoregulation and how spinal cord injuries disrupt this process. It also provides practical guidance for managing abnormal temperature control in patients with spinal cord injuries. This includes approaches such as monitoring core temperature, providing adequate heating or cooling, and addressing any underlying medical conditions that may be contributing to temperature fluctuations.
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References
Alexander MS, Biering-Sorensen F, Bodner D, et al. International standards to document remaining autonomic function after spinal cord injury. Spinal Cord. 2009;47:36–43.
American Spinal Injury Association (ASIA). International standards to document remaining autonomic function after spinal cord injury. 1st ed. Atlanta, GA: American Spinal Injury Association; 2012.
Attia M, Engel P. Thermoregulatory set point in patients with spinal cord injuries (spinal man). Paraplegia. 1983;21:233–48.
Biering-Sørensen F, Alexander MS, van Asbeck FWA, et al. Version 1.1 of the international spinal cord injury skin and thermoregulation function basic data set. Spinal Cord. 2017;55:566–9.
Colachis SC 3rd, Otis SM. Occurrence of fever associated with thermoregulatory dysfunction after acute traumatic spinal cord injury. Am J Phys Med Rehabil. 1995;74:114–9.
Coon EA, Cheshire WP Jr. Sweating disorders. Continuum (Minneap Minn). 2020;26:116–37.
Downey JA, Chiodi HP, Darling RC. Central temperature regulation in the spinal man. J Appl Physiol. 1967;22:91–4.
Guttmann L, Silver J, Wyndham CH. Thermoregulation in spinal man. J Physiol. 1958;142:406–19.
Handrakis JP, Trbovich M, Hagen EM, et al. Thermodysregulation in persons with spinal cord injury: case series on use of the autonomic standards. Spinal Cord Ser Cases. 2017;3:17086.
Karlsson AK, Krassioukov A, Alexander MS, et al. International spinal cord injury skin and thermoregulation function basic data set. Spinal Cord. 2012;50:512–6.
Kellogg DL, Pergola PE, Piest KL, et al. Cutaneous active vasodilation in humans is mediated by cholinergic nerve cotransmission. Circ Res. 1995;77:1222–8.
Khan S, Plummer M, Martinez-Arizala A, et al. Hypothermia in patients with chronic spinal cord injury. J Spinal Cord Med. 2007;30:27–30.
Krassioukov A, Biering-Sørensen F, Donovan W, et al. International standards to document remaining autonomic function after spinal cord injury. J Spinal Cord Med. 2012;35:201–10.
Menard MR, Hahn G. Acute and chronic hypothermia in a man with spinal cord injury: environmental and pharmacologic causes. Arch Phys Med Rehabil. 1991;72:421–4.
Minson CT, Brunt VE. Chapter 7. Thermoregulatory considerations for the performance of exercise in SCI. In: Taylor JA, editor. The physiology of exercise in spinal cord injury. New York: Springer; 2016.
Minson CT, Wladkowski SL, Pawelczyk JA, et al. Age, splanchnic vasoconstriction, and heat stress during tilting. Am J Phys. 1999;276(1 Pt 2):R203–12.
Mitchell D, Laburn HP. Pathophysiology of temperature regulation. Physiologist. 1985;28:507–17.
Normell LA. Distribution of impaired cutaneous vasomotor and sudomotor function in paraplegic man. Scand J Clin Lab Invest Suppl. 1974;138:25–41.
Sawka MN, Latzka WA, Pandolf KB. Temperature regulation during upper body exercise: able-bodied and spinal cord injured. Med Sci Sports Exerc. 1989;21(5 Suppl):S132–S40.
Pallubinsky H, Schellen L, van Marken Lichtenbelt WD. Exploring the human thermoneutral zone—a dynamic approach. J Therm Biol. 2019;79:199–208.
Phillips WT, Kiratli BJ, Sarkarati M, et al. Effect of spinal cord injury on the heart and cardiovascular fitness. Curr Probl Cardiol. 1998;23:641–716.
Price MJ. Thermoregulation during exercise in individuals with spinal cord injuries. Sports Med. 2006;36:863–79.
Price MJ, Trbovich M. Thermoregulation following spinal cord injury. Handb Clin Neurol. 2018;157:799–820.
Schmidt KD, Chan CW. Thermoregulation and fever in normal persons and in those with spinal cord injuries. Mayo Clin Proc. 1992;67:469–75.
Sessler DI. Thermoregulatory defense mechanisms. Crit Care Med. 2009;37(7 Suppl):S203–10.
Struhal W, Lahrmann H, Fanciulli A, et al., editors. Bedside approach to autonomic disorders. A clinical tutor. Cham: Springer; 2017.
Tan CL, Knight ZA. Regulation of body temperature by the nervous system. Neuron. 2018;98:31–48.
Wecht JM, Krassioukov AV, Alexander M, et al. International standards to document autonomic function following SCI (ISAFSCI): second edition. Top Spinal Cord Inj Rehabil. 2021;27:23–49.
Wecht JM, La Fountaine MF, Handrakis JP, et al. Autonomic nervous system dysfunction following spinal cord injury: cardiovascular, cerebrovascular, and thermoregulatory effects. Curr Phy Med Rehabil Rep. 2015;3:197–205.
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Ko, HY. (2023). Abnormal Temperature Control After Spinal Cord Injuries. In: A Practical Guide to Care of Spinal Cord Injuries. Springer, Singapore. https://doi.org/10.1007/978-981-99-4542-9_31
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DOI: https://doi.org/10.1007/978-981-99-4542-9_31
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