Thermosensitivity of the goat's brain

Interdependency of Core Temperature and Glabrous Skin Blood Flow in Human Thermoregulation Function: A Pilot Study

Human thermoregulation is governed by a complex, nonlinear feedback control system. The system consists of thermoreceptors, a controller, and effector mechanisms for heat exchange that coordinate to maintain a central core temperature. A principal route for heat flow between the core and the environment is via convective circulation of blood to arteriovenous anastomoses located in glabrous skin of the hands and feet. This paper presents new human experimental data for thermoregulatory control behavior along with a coupled, detailed control system model specific to the interdependent actions of core temperature and glabrous skin blood flow (GSBF) under defined transient environmental thermal stress. The model was tuned by a nonlinear least-squared curve fitting algorithm to optimally fit the experimental data. Transient GSBF in the model is influenced by core temperature, nonglabrous skin temperature, and the application of selective thermal stimulation. The core temperature in the model is influenced by integrated heat transfer across the nonglabrous body surface and GSBF. Thus, there is a strong cross-coupling between GSBF and core temperature in thermoregulatory function. Both variables include a projection term in the model based on the average rates of their change. Six subjects each completed two thermal protocols to generate data to which the common model was fit. The model coefficients were unique to each of the twelve data sets but produced an excellent agreement between the model and experimental data for the individual trials. The strong match between the model and data confirms the mathematical structure of the control algorithm.

Peripheral thermoreceptors in innocuous temperature detection

The mammalian skin is innervated by cold-sensitive afferent neurons. These neurons exhibit ongoing activity at temperatures between ~10 and 42°C, are activated by innocuous cold stimuli, inhibited by warm stimuli and are mechanoinsensitive. Their axons are small-diameter myelinated (Aδ-) fibers in primates and unmyelinated (C-) fibers in nonprimate mammals. The mammalian skin is innervated by warm-sensitive afferent neurons. The density of innervation by these neurons is lower than that by cold-sensitive afferents. They exhibit ongoing activity between ~38 and 48°C, are activated by warm stimuli, inhibited by cold stimuli, and are mechanoinsensitive. Their axons are unmyelinated (C-) fibers. Cold-sensitive unmyelinated afferent neurons exhibit prominent cold sensitivity of their axons (in rats). The discharge pattern of the cutaneous cold-sensitive afferent neurons is fully preserved after nerve injury. Ongoing impulse activity and cold-evoked impulses originate ectopically at the nerve injury site. Deep somatic tissues and viscera are innervated by thermosensitive afferent neurons. Most are warm-sensitive and mechanoinsensitive and have unmyelinated axons. These afferent neurons have only rarely and incompletely been studied, e.g., in the upper gastrointestinal tract, the liver (both vagal afferents), the dorsal abdominal wall, and the skeletal muscle. Spinal cord warm sensitivity may be mediated by cutaneous afferent neurons with unmyelinated axons that are excited by spinal cord warming.

Spinal cord thermosensitivity: An afferent phenomenon?

We review the evidence for thermoregulatory temperature sensors in the mammalian spinal cord and reach the following conclusions. 1) Spinal cord temperature contributes physiologically to temperature regulation. 2) Parallel anterolateral ascending pathways transmit signals from spinal cooling and spinal warming: they overlap with the respective axon pathways of the dorsal horn neurons that are driven by peripheral cold- and warm-sensitive afferents. 3) We hypothesize that these ‘cold’ and ‘warm’ ascending pathways transmit all extracranial thermosensory information to the brain. 4) Cutaneous cold afferents can be activated not only by cooling the skin but also by cooling sites along their axons: we consider that this is functionally insignificant in vivo. 5) By a presynaptic action on their central terminals, local spinal cooling enhances neurotransmission from incoming ‘cold’ afferent action potentials to second order neurons in the dorsal horn; this effect disappears when the spinal cord is warm. 6) Spinal warm sensitivity is due to warm-sensitive miniature vesicular transmitter release from afferent terminals in the dorsal horn: this effect is powerful enough to excite second order neurons in the ‘warm’ pathway independently of any incoming sensory traffic. 7) Distinct but related presynaptic mechanisms at cold- and warm-sensitive afferent terminals can thus account for the thermoregulatory actions of spinal cord temperature.

Selective brain cooling in mammals and birds

Artiodactyls and felids have a carotid rete that can cool the blood destined for the brain and consequently the brain itself if the cavernous sinus receives cool blood returning from the nose. This condition is usually fulfilled in resting and moderately hyperthermic animals. During severe exercise hyperthermia, however, the venous return from the nose bypasses the cavernous sinus so that brain cooling is suppressed. This is irreconcilable with the assumption that the purpose of selective brain cooling (SBC) is to protect the brain from thermal damage. Alternatively, SBC is seen as a mechanism engaging the thermoregulatory system in a water-saving economy mode in which evaporative heat loss is inhibited by the effects of SBC on brain temperature sensors. In nonhuman mammals that do not have a carotid rete, no evidence exists of whole-brain cooling. However, the surface of the cavernous sinus is in close contact with the base of the brain and is the likely source of unregulated regional cooling of the rostral brain stem in some species. In humans, the cortical regions next to the inner surface of the cranium are very likely to receive some regional cooling via the scalp-sinus pathway, and the rostral base of the brain can be cooled by conduction to the nearby respiratory tract; mechanisms capable of cooling the brain as a whole have not been found. Studies using conventional laboratory techniques suggest that SBC exists in birds and is determined by the physical conditions of heat transfer from the head to the environment instead of physiological control mechanisms. Thus except for species possessing a carotid rete, neither a coherent pattern of SBC nor a unifying concept of its biological significance in mammals and birds has evolved.

Fever as the initial sign of malfunction in non infected ventriculoperitoneal shunts

Sixty eight children were treated for ventriculoperitoneal shunt malfunction in our department during the years 1984-1989. Fifteen (22%) developed fever above 37.5 degrees C as a presenting sign of their shunt malfunction. Physical examination did not reveal any reason for the fever. Cerebrospinal fluid, urine and blood cultures were all negative. All the children were operated upon and the malfunction corrected. Fever subsided twenty four to thirty six hours after the operation in all the patients. Fever of unknown origin in children with shunted hydrocephalus might be the first sign of a developing shunt malfunction and a neurosurgical examination should be requested.

Threshold and slope of selective brain cooling

Experiments (n = 50) in three conscious goats were performed in a thermoneutral environment to determine the threshold (i.e. the point at which the brain temperature is equal to the carotid blood temperature) and slope (i.e. the difference between brain and carotid blood temperatures as a function of carotid blood temperature) of selective brain cooling (SBC) and analyse the thermal inputs affecting them. Prior to the experiments the animals received carotid loops and an arteriovenous shunt to manipulate head and trunk temperatures independently of each other. The mean SBC threshold was 38.75 degrees C T(carotis) and independent of T(trunk). When body core temperature was increased from a hypo- to a moderately hyperthermic level, the SBC threshold was passed before metabolic rate had reached its minimum and before cutaneous vasodilation occurred. The mean SBC slope was 0.78 and rose with increasing Ttrunk. The degree of SBC was principally independent of respiratory heat loss: high levels of heat loss were found without SBC, and large degrees of SBC were observed at low levels of heat loss. The effect of SBC in and around normothermia is to smooth the onset of shivering or panting and to establish a range of internal temperature within which metabolic rate and respiratory heat loss are simultaneously at low levels.