1. ECTRIMS/ACTRIMS’99
September , 1999
Basel, Switzerland
Evaluation of Lowering Body Temperature to Facilitate Neurocognitive Function in People with Multiple Sclerosis by
Leslie D. Montgomery, Ph.D.
Richard W. Montgomery, Ph.D.
Yu-Tsuan E. Ku, M.S.
Bernadette Luna, M.S.
Hank C. Lee, B.S.
Bruce W. Webbon, Ph.D.

2. Background
Approximately % of MS patients exhibit some degree of cognitive impairment
Body cooling is used to provide temporary relief of the symptoms of MS
NASA, Lockheed Martin, and MSAA co-sponsored research to evaluate the use of liquid cooling garments to benefit people with MS

3. Objectives
To demonstrate that a controlled period of head and torso cooling will enhance the cognitive performance of multiple sclerosis patients and
To gain insight into the neurological effects of cooling

4. Methods Tested 12 healthy men 8 healthy women
Tested 11 MS men 8 MS women
Cooled 1 hour LET head/vest garment
Pre/Post EEG - VEPs (Reversing Grid)
Pre/Post Rao neuropsychological tests
Biolog thermal/physiological monitoring
1. Good morning, today I’d like to introduce you to a rather unique effort, our Multiple Sclerosis Technology Transfer Program.
2. My name is Leslie Montgomery; I am the Lockheed Martin Program Manager of this program. I will be giving you a brief overview of our work. My colleague, Yu-Tsuan Ku will be giving you some of the results of our research later in this presentation.
3. I would also like to introduce Dr. Bruce Webbon, the NASA Principal Investigator of this program.

5. Active cooling garment used by MS patients during investigation
1. These are some of the commercially available cooling garments worn by MS patients that we have used in our research to compare the effectiveness of these garments.
2. Basically, there are two types of vests. The “active” cooling vest which circulates a coolant through tubes in the petches of the garment and removes body heat back to the heat sink.
3.The other type is the “passive’ vests which use either blue ice or frozen gel packs placed in pouches of the garment to cool the body.
4. We have one of each these vest with us, if you like to try them on after the presentation.

6. Analysis of topographic electroencephalographic data
Record EEG using International electrode placement
Overlay individual stimulus epochs to obtain multi-electrode ERP
Fit a regression surface to the grid of voltage values at each sample time
Compute 2nd spatial derivatives (Laplacians) of the voltage surface at each scalp location and sample time
For each sample time, use Poisson’s equation to compute charge density at each scalp location from the Laplacians

7. Comparison of voltage and charge density visual evoked responses

8. Change of temperature vs. elapsed time
CTL COOLING REC RAO TEST
ORAL (°C)
RECTAL (°C)
CTL COOLING REC RAO TEST
RT EAR (°C)
SKIN (°C)
CTL COOLING REC RAO TEST
CTL COOLING REC RAO TEST

9. 10/36 Spatial Recall Test 4/11 3/8
Relative improvement of male and female MS subjects on Rao neuropsychological test battery
Male Female
Selective Reminding Test /11 5/8
10/36 Spatial Recall Test 4/11 3/8
Symbol Digit Modalities Test 2/11 6/8
Paced Auditory Addition Test
Three Sec. Interval 6/11 6/8
Two Sec. Interval 4/11 5/8

10. Relation between pre-cooling EEG and post-cooling performance

11. Level 1 - MS patient with extensive demyelination

12. Level 2 - MS patient with moderate demyelination

13. Level 3 - MS patient with little demyelination

14. Schauf and Davis model of conduction
in a partially demyelinated nerve 1

15. Summary
Head and torso cooling may be effective in lowering “core” temperature of MS patients.
Cooling improves cognition for patients with substantial, but not extreme, impairment.
EEG - VEP (Grid) charge density analysis may be used as screening metric for determining those who might benefit cognitively from cooling.

16. Acknowledgement
This research was conducted as part of the NASA Multiple Sclerosis Technology Transfer Program and was cofunded by NASA, Lockheed Martin, and the Multiple Sclerosis Association of America.
For more information about our work:
or contact

17. Suggested reading
J . S. Fischer, et. al. “What do we really know about cognitive dysfunction, affective disorders, and stress in multiple sclerosis? A practitioner’s guide,” J. Neuro. Rehab. 8(3): (1994).
R. W. Montgomery, L. D. Montgomery, R. Guisado. “Electroencephalographic scalp energy analysis as a tool for investigation of cognitive performance,” J. Biomed. Inst. Tech. 27(2): (1993).
C. L. Schauf, F. A. Davis. “Impulse conduction in multiple sclerosis: A theoretical basis for modification by temperature and pharmacological agents,” J. Neurol. Neurosurg. Psychiatry 37: (1974)