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Grajales-Reyes JG, Chen B, Meseguer D, Schneeberger M. Burning Question: How Does Our Brain Process Positive and Negative Cues Associated with Thermosensation? Physiology (Bethesda) 2024; 39:0. [PMID: 38536114 PMCID: PMC11368520 DOI: 10.1152/physiol.00034.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 03/06/2024] [Accepted: 03/22/2024] [Indexed: 05/16/2024] Open
Abstract
Whether it is the dramatic suffocating sensation from a heat wave in the summer or the positive reinforcement arising from a hot drink on a cold day; we can certainly agree that our thermal environment underlies our daily rhythms of sensation. Extensive research has focused on deciphering the central circuits responsible for conveying the impact of thermogenesis on mammalian behavior. Here, we revise the recent literature responsible for defining the behavioral correlates that arise from thermogenic fluctuations in mammals. We transition from the physiological significance of thermosensation to the circuitry responsible for the autonomic or behavioral responses associated with it. Subsequently, we delve into the positive and negative valence encoded by thermoregulatory processes. Importantly, we emphasize the crucial junctures where reward, pain, and thermoregulation intersect, unveiling a complex interplay within these neural circuits. Finally, we briefly outline fundamental questions that are pending to be addressed in the field. Fully deciphering the thermoregulatory circuitry in mammals will have far-reaching medical implications. For instance, it may lead to the identification of novel targets to overcome thermal pain or allow the maintenance of our core temperature in prolonged surgeries.
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Affiliation(s)
- Jose G Grajales-Reyes
- Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut, United States
| | - Bandy Chen
- Department of Cellular and Molecular Physiology, Laboratory of Neurovascular Control of Homeostasis, Yale School of Medicine, New Haven, Connecticut, United States
- Wu Tsai Institute for Mind and Brain, Yale University, New Haven, Connecticut, United States
| | - David Meseguer
- Department of Cellular and Molecular Physiology, Laboratory of Neurovascular Control of Homeostasis, Yale School of Medicine, New Haven, Connecticut, United States
- Wu Tsai Institute for Mind and Brain, Yale University, New Haven, Connecticut, United States
| | - Marc Schneeberger
- Department of Cellular and Molecular Physiology, Laboratory of Neurovascular Control of Homeostasis, Yale School of Medicine, New Haven, Connecticut, United States
- Wu Tsai Institute for Mind and Brain, Yale University, New Haven, Connecticut, United States
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Ntoumani M, Dugué B, Rivas E, Gongaki K. Thermoregulation and thermal sensation during whole-body water immersion at different water temperatures in healthy individuals: A scoping review. J Therm Biol 2023; 112:103430. [PMID: 36796887 DOI: 10.1016/j.jtherbio.2022.103430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 11/08/2022] [Accepted: 12/14/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Severe thermal discomfort may increase risk of drowning due to hypothermia or hyperthermia from prolonged exposure to noxious water temperatures. The importance of using a behavioral thermoregulation model with thermal sensation may predict the thermal load that the human body receives when exposed to various immersive water conditions. However, there is no thermal sensation "gold standard" model specific for water immersion. This scoping review aims to present a comprehensive overview regarding human physiological and behavioral thermoregulation during whole-body water immersion and explore the feasibility for an accepted defined sensation scale for cold and hot water immersion. METHODS A standard literary search was performed on PubMed, Google Scholar, and SCOPUS. The words "Water Immersion," "Thermoregulation," "Cardiovascular responses" were used either as independent searched terms and MeSH terms (Medical Subject Headings) or in combination with other text words. The inclusion criteria for clinical trials terms to thermoregulatory measurements (core or skin temperature), whole-body immersion, 18-60 years old and healthy individuals. The prementioned data were analyzed narratively to achieve the overall study objective. RESULTS Twenty-three published articles fulfilled the review inclusion/exclusion criteria (with nine measured behavioral responses). Our outcomes illustrated a homogenous thermal sensation in a variety of water temperatures ranges, that was strongly associated with thermal balance, and observed different thermoregulatory responses. This scoping review highlights the impact of water immersion duration on human thermoneutral zone, thermal comfort zone, and thermal sensation. CONCLUSION Our findings enlighten the significance of thermal sensation as a health indicator for establishing a behavioral thermal model applicable for water immersion. This scoping review provides insight for the needed development of subjective thermal model of thermal sensation in relation to human thermal physiology specific to immersive water temperature ranges within and outside the thermal neutral and comfort zone.
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Affiliation(s)
- Maria Ntoumani
- National & Kapodistrian University of Athens, Medical School, Department of Physiology, 11527, Athens, Greece; National & Kapodistrian University of Athens, School of Physical Education and Sport Science, Philosophy Division, 17237, Athens, Greece.
| | - Benoit Dugué
- Université de Poitiers, Faculté des Sciences du Sport, UR 20296, Laboratoire "Mobilité, Vieillissement et Exercice (MOVE)", 86000, Poitiers, France
| | - Eric Rivas
- KBR, Human Physiology, Performance, Protection & Operations Laboratory, NASA Johnson Space Center, 77058, Houston, Texas, USA
| | - Konstantina Gongaki
- National & Kapodistrian University of Athens, School of Physical Education and Sport Science, Philosophy Division, 17237, Athens, Greece
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Mühlenpfordt I, Blakeslee SB, Everding J, Cramer H, Seifert G, Stritter W. Touching body, soul, and spirit? Understanding external applications from integrative medicine: A mixed methods systematic review. Front Med (Lausanne) 2022; 9:960960. [PMID: 36619637 PMCID: PMC9813495 DOI: 10.3389/fmed.2022.960960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction External applications from anthroposophic medicine (EAAM) are touch-based applications such as rhythmical massages, embrocations, and compresses that serve as components of complementary treatment concepts for various diseases. The aim of this review is to gain an understanding of typical indications and outcomes and to systematically assess the effectiveness and safety of EAAM. Materials and methods Medline/PubMed, CINAHL, the Cochrane Library, Embase, and PsycINFO were searched through May 2021 and supplemented by searches in specialized databases and personal requests to experts in the field. Studies and case reports on EAAM in patients, as well as healthy individuals, were included in the qualitative synthesis. Outcome parameters depending on each study were grouped as effect themes and assigned to study clusters using Thematic Analysis for a thematic overview of effect patterns. Results Four RCTs, 7 cohort studies, 1 mixed-methods, 1 retrospective, 4 qualitative studies, 3 case series, and 25 case reports on EAAM were identified. The analysis indicated various effects of EAAM on physiological as well as psychological health indicators and patterns of effect development. Study quality was found to be high for only 2 studies, and moderate for 1 study, and all remaining 45 studies showed a moderate or high risk of bias or were not ratable with used rating tools. Conclusion The included studies present a wide range of potential indications for EAAM, while showing methodological drawbacks. To determine whether EAAM can be considered an effective treatment option, clinical studies exploring the effect of different EAAM modalities on defined patient groups are recommended for the future. Systematic review registration [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214030], identifier [CRD42020214030].
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Affiliation(s)
- Inga Mühlenpfordt
- Department of Pediatrics, Division of Oncology and Hematology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany,*Correspondence: Inga Mühlenpfordt,
| | - Sarah B. Blakeslee
- Department of Pediatrics, Division of Oncology and Hematology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Janina Everding
- Department of Pediatrics, Division of Oncology and Hematology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Holger Cramer
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany,Bosch Health Campus, Stuttgart, Germany
| | - Georg Seifert
- Department of Pediatrics, Division of Oncology and Hematology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany,Department of Pediatrics, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Wiebke Stritter
- Department of Pediatrics, Division of Oncology and Hematology, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
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Do Chest Compresses with Mustard or Ginger Affect Warmth Regulation in Healthy Adults? A Randomized Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:5034572. [PMID: 35899230 PMCID: PMC9313983 DOI: 10.1155/2022/5034572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022]
Abstract
Background Chest compresses with mustard (MU) or ginger (GI) are a complementary treatment option for respiratory tract infections. However, little is known about their specific thermogenic qualities. This study examines the short-term effects of MU, GI, and chest compresses with warm water only (WA) on measurable and self-perceived body warmth in healthy adults. Methods This was a single-center, randomized controlled trial with cross-over design (WA versus MU versus GI). 18 participants (23.7 ± 3.4 years; 66.7% female) received MU, GI, and WA in a random order on three different days with a mean washout period of 13.9 days. Chest compresses were applied to the thoracic back for a maximum of 20 minutes. The primary outcome measure was skin temperature of the posterior trunk (measured by infrared thermography) immediately following removal of the compresses (t1). Secondary outcome measures included skin temperature of the posterior trunk 10 minutes later (t2) and several parameters of self-perceived warmth at t1 and t2 (assessed with the Herdecke Warmth Perception Questionnaire). Results Skin temperature of the posterior trunk was significantly higher with MU compared to WA and GI at t1 (p < 0.001 for both, primary outcome measure) and t2 (WA versus MU: p=0.04, MU versus GI: p < 0.01). Self-perceived warmth of the posterior trunk was higher with MU and GI compared to WA at t1 (1.40 ≥ d ≥ 1.79) and remained higher with GI at t2 (WA versus GI: d = 0.74). The overall warmth perception increased significantly with GI (d = 0.69), tended to increase with MU (d = 0.54), and did not change with WA (d = 0.36) between t0 and t1. Conclusions Different effects on warmth regulation were observed when ginger and mustard were applied as chest compresses. Both substances induced self-perceived warming of the posterior trunk, but measurable skin temperature increased only with MU. Further research is needed to examine the duration of these thermogenic effects and how chest compresses with ginger or mustard might be incorporated into practice to influence clinical outcomes in respiratory tract infections.
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Surgery as an Emotional Strain: An Observational Study in Patients Undergoing Elective Colorectal Surgery. J Clin Med 2022; 11:jcm11102712. [PMID: 35628839 PMCID: PMC9146204 DOI: 10.3390/jcm11102712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/21/2022] [Accepted: 05/09/2022] [Indexed: 02/01/2023] Open
Abstract
Recent research suggests an impact of psychological distress on postoperative outcomes in orthopedic and neurosurgery. It is widely unknown whether patients' mood might affect the postoperative outcome and complication rate in colorectal surgery. Over a period of 22 months, a monocentric, observational study among patients undergoing elective colorectal surgery without the creation of an ostomy was conducted. Patients were asked to fill in a standardized multi-dimensional mood questionnaire (MDMQ) preoperatively as well as on the third, sixth, and ninth postoperative days to assess mood, wakefulness, and arousal. The results of 80 patients (51% male, mean age 59 years) were analyzed. Almost half of the patients (58%) developed postoperative complications according to the Clavien-Dindo classification (Grade I 14%, Grade II 30%, Grade III 9%, Grade IV 3%). Patients' mood increased continually from the preoperative day to the ninth postoperative day. Patients' wakefulness decreased initially (pre- to third postoperative day) and increased again in the further course. Patients' arousal decreased pre- to postoperatively. Neither preoperative mood, nor arousal or wakefulness of patients showed a clear association with the development of postoperative complications. In conclusion, preoperative psychological distress measured by MDMQ did not affect the postoperative complication rate of patients undergoing elective colorectal surgery.
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Schulz S, Stritter W, Gross MM, Miltner D, Rapp D, Wilde B, Eggert A, Schroeder R, Voss A, Seifert G. Quantification of Cardiovascular Regulation Applying Heart Rate Variability Analyses for Different Warm and Moist Chest Compresses in Healthy Subjects. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:268-277. [PMID: 35244456 PMCID: PMC8971996 DOI: 10.1089/jicm.2021.0252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: In integrative medicine, complementary healing methods, such as external applications (massages, rhythmic rubs, and compresses), are part of the practice and clinical application and have proven their therapeutic effect in various fields. Objective: Aim of this exploratory, controlled, single-blinded study was to investigate the effects of three different warming chest compresses on cardiovascular regulation by analyzing heart rate variability (HRV) in healthy subjects. Methods: Over a period of 4 weeks, three different warming chest compresses (a hot water compress, a ginger powder compress, and a mustard flour compress) in 30 healthy subjects were analyzed. For all subjects, 48-h long-term electrocardiograms were recorded, and afterward, epochs of 5 min length extracted and analyzed by different linear and nonlinear HRV indices. Results: A moist chest compress did not result in any significant short- and long-term stimulation of the autonomic regulation, except for a short-term significant decrease in heart rate (meanNN, p < 0.05). Warm and moist chest compresses with ginger flour led to significantly increased HRV (sdNN, p < 0.05; symbolic dynamics2, p < 0.05) and its complexity (renyi4 entropy, p < 0.05) and a significant decrease in heart rate (meanNN, p < 0.00036), and thus to a short-term relaxation effect. In contrast, warm and moist chest compresses with mustard flour led to significantly decreased HRV and their complexity (time-, frequency-, and nonlinear dynamics domain, p < 0.00036), which can be interpreted as a stress reaction of the autonomous nervous system. Conclusions: The application of chest compresses led to short-term relaxation effects (ginger) as well as short-term stress effects (mustard) but not to any significant longer-term effect on HRV in healthy subjects.
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Affiliation(s)
- Steffen Schulz
- Division of Oncology and Hematology, Department of Pediatrics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Wiebke Stritter
- Division of Oncology and Hematology, Department of Pediatrics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Marie Michelle Gross
- Division of Oncology and Hematology, Department of Pediatrics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | | | - Doris Rapp
- Clinic for Anthroposophic Medicine, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Britta Wilde
- Clinic for Anthroposophic Medicine, Gemeinschaftskrankenhaus Havelhöhe, Berlin, Germany
| | - Angelika Eggert
- Division of Oncology and Hematology, Department of Pediatrics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | | | - Andreas Voss
- Division of Oncology and Hematology, Department of Pediatrics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Institute of Biomedical Engineering and Informatics, University of Technology Ilmenau, Ilmenau, Germany
| | - Georg Seifert
- Division of Oncology and Hematology, Department of Pediatrics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Pediatrics, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.,Address correspondence to: Georg Seifert, MD, Division of Oncology and Hematology, Department of Pediatrics, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Pädiatrie m.S. Onkologie/Hämatologie/SZT, Augustenburger Platz 1, Berlin 13353, Germany
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Tröndle M, Stritter W, Odone V, Peron K, Ghelman R, Seifert G. Beyond the Standard of Care: An Exploratory Qualitative Study of an Implemented Integrative Therapeutic Care Program in a Brazilian Pediatric Oncology Unit. J Altern Complement Med 2021; 27:1002-1010. [PMID: 34668735 DOI: 10.1089/acm.2021.0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: This article examines the feedback of health care providers within the implementation of an integrative care project in a clinic for pediatric oncology in São Paulo, Brazil. Since 2017, the project has implemented external anthroposophic therapies in the activities of daily nursing. The objective is to evaluate how the project evolved and what impact it had on the daily operation of the hospital. A special focus emphasizes the perspective of study nurses. Materials and Methods: Twelve qualitative semistructured interviews were conducted. Audio files were transcribed, translated to German, and underwent a MAXQDA software-assisted analysis. Using a thematic approach, coherent cross-case topics were defined. Results: Three main topics emerged from analysis of the data. (1) The implementation and its effects on daily patient care demonstrated positive outcomes in patients and were well accepted with minimal changes in daily activities. (2) The perspective of study nurses showed a large motivation due to beneficial and stress-relieving effects of the application and a growing patient-health care provider relationship. (3) Problems and aspirations for improvement were the lack of time and the urge to make the project grow in the future. Conclusion: Not only patients but also health care providers seem to benefit from integrative methods. They have the potential to improve the working atmosphere and to strengthen relations between patients, caregivers, and family members. General feedback was positive and acceptance in the team arose over time when beneficial effects became visible.
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Affiliation(s)
- Marc Tröndle
- Department of Pediatric Oncology/Hematology, Otto-Heubner Centre for Pediatric and Adolescent Medicine (OHC), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Wiebke Stritter
- Department of Pediatric Oncology/Hematology, Otto-Heubner Centre for Pediatric and Adolescent Medicine (OHC), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Vicente Odone
- Departamento de Pediatria, Faculdade de Medicina, Instituto de Tratamento do Câncer Infantil (ITACI), Universidade de São Paulo, São Paulo, Brazil
| | - Karina Peron
- Departamento de Pediatria, Faculdade de Medicina, Instituto de Tratamento do Câncer Infantil (ITACI), Universidade de São Paulo, São Paulo, Brazil
| | - Ricardo Ghelman
- Departamento de Pediatria, Faculdade de Medicina, Instituto de Tratamento do Câncer Infantil (ITACI), Universidade de São Paulo, São Paulo, Brazil
| | - Georg Seifert
- Department of Pediatric Oncology/Hematology, Otto-Heubner Centre for Pediatric and Adolescent Medicine (OHC), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Departamento de Pediatria, Faculdade de Medicina, Instituto de Tratamento do Câncer Infantil (ITACI), Universidade de São Paulo, São Paulo, Brazil
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