Selective brain cooling (SBC) of varying strengths has been demonstrated in a number of mammals and appears to play a role in systemic thermoregulation. Although primates lack obvious specialization for SBC, the possibility of brain cooling in humans has been debated for many years. This paper reports on the use of mathematical modeling to explore whether surface cooling can control effectively the temperature of the human cerebrum. The brain was modeled as a hemisphere with a volume of 1.33 1 and overlying layers of cerebrospinal fluid, skull, and scalp. Each component was assigned appropriate dimensions, physical properties and physiological characteristics that were determined from the literature. The effects of blood flow and of thermal conduction were modeled using the steady-state form of the bio-heat equation. Input parameters included core (arterial) temperature: normal (37 degrees C) or hyperthermic (40 degrees C), air temperature: warm (30 degrees C) or hot (40 degrees C), and sweat evaporation rate: 0, 0.25, or 0.50 l x m(-2) x h(-1). The resulting skin temperatures of the model ranged from 31.8 degrees C to 40.2 degrees C, values which are consistent with data obtained from the literature. Cerebral temperatures were generally insensitive to surface conditions (air temperature and evaporation rate), which affected only the most superficial level of the cerebrum (< or =1.5 mm) The remaining parenchymal temperatures were 0.2-0.3 degrees C above arterial temperatures, regardless of surface conditions. This held true even for the worst-case conditions combining core hyperthermia in a hot environment with zero evaporative cooling. Modeling showed that the low surface-to-volume ratio, low tissue conductivity, and high rate of cerebral perfusion combine to minimize the potential impact of surface cooling, whether by transcranial venous flow or by conduction through intervening layers to the skin or mucosal surfaces. The dense capillary network in the brain assures that its temperature closely follows arterial temperature and is controlled through systemic thermoregulation independent of head surface temperature. A review of the literature reveals several independent lines of evidence which support these findings and indicate the absence of functionally significant transcranial venous flow in either direction. Given the fact that humans sometimes work under conditions which produce face and scalp temperatures that are above core temperature, a transcranial thermal link would not necessarily protect the brain, but might instead increase its vulnerability to environmentally induced thermal injury.
Whole body hyperthermia may produce vasodialation, nausea, and altered cognitive function. Animal research has identified brain regions that have important roles in thermoregulation. However, differences in both the cognitive and sweating abilities of humans and animals implicate the need for human research. Positron emission tomography (PET) was used to identify brain regions with altered activity during systemic hyperthermia. Human subjects were studied under cool (control) conditions and during steady-state hyperthermia induced by means of a liquid-conditioned suit perfused with hot water. PET images were obtained by injecting [(18)F]fluorodeoxyglucose, waiting 20 min for brain uptake, and then scanning for 10 min. Heating was associated with a 23% increase in resting metabolic rate. Significant increases in cerebral metabolic rate occurred in the hypothalamus, thalamus, corpus callosum, cingulate gyrus, and cerebellum. In contrast, significant decreases occurred in the caudate, putamen, insula, and posterior cingulum. These results are important for understanding the mechanisms responsible for altered cognitive and systemic responses during hyperthermia. Novel regions (e.g., lateral cerebellum) with possible thermoregulatory roles were identified.
The thermoregulatory responses of menstruant women to exercise in dry heat (dry-bulb temperature/wet-bulb temperature = 48/25 degrees C) were evaluated at three times during the menstrual cycle: menstrual flow (MF), 3-5 days during midcycle including ovulation (OV), and in the middle of the luteal phase (LU). Serum concentrations of estradiol-17 beta (E2), progesterone (Pg), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured by radioimmunoassay, and these values were used to determine the dates of OV (peak LH and FSH) and LU (peak postovulatory Pg). After heat acclimation, subjects received heat stress tests (HST) consisting of a 2-h cycle-ergometer exercise at 30% of maximal O2 consumption in the heat. Rectal (Tre) and mean skin (Tsk) temperatures, heart rate (HR), and sweat rate on the chest and thigh were recorded continuously. Total sweat loss (Msw), as indicated by weight loss, was recorded every 20 min, and equivalent water replacement was given. Steady-state exercise metabolic rate (M) was measured at 45 and 110 min. Seven of eight subjects had ovulatory cycles during experimental months. At rest, Tre was lowest at OV and significantly higher at LU. During steady-state exercise both Tre and Tsk were lowest at OV and significantly higher at LU. There were no differences between phases in Msw, sweat rate on the chest and thigh or M. Despite higher Tre and Tsk at LU, all subjects were able to complete the 2-h of exercise.(ABSTRACT TRUNCATED AT 250 WORDS)
Circulatory fluid shifts were studied in middle-aged runners (6 males and 5 females, ages 32-58 yr) during a 42.2-km marathon race run in mild weather (dry-bulb temperature = 17.5-20.4 degrees C). Running times for the subjects were 3:12-4:40 (mean values were 3:34 for males and 4:10 for females). Venous blood samples were taken without stasis in all subjects seated at rest before the start of the race and within 3 min of finishing; eight of the subjects also paused for samples at 6 and 27 km during the race. At 6 km, body weight loss averaged less than 1%, whereas plasma volume (PV) had decreased by 6.5% in male subjects and 8.6% in female subjects. By the end of the race, hypohydration had reached 3.2% in male subjects and 2.9% in female subjects, but PV in both groups remained stable. Sweat rates during the race averaged 545 and 429 g X m-2 X h-1 for male and female subjects, respectively, with ad lib. water intake replacing 21-72% of fluid loss. Increases in plasma protein concentration throughout the race reflected the observed initial decrease in PV. The interpretation of PV responses to exercise and/or hypohydration is critically dependent on selection of base-line conditions; we were able to control for posture-exercise effects by treating the early exercise (6 km) sample as the base line for examining the effects of later fluid loss. Under these conditions, the vascular compartment resisted volume depletion. The ability to maintain stable PV can be explained in part by relationships among oncotic and hydrostatic pressures in the intra- and extravascular fluid compartments.
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