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Thermoregulation

Thermoregulation

The human body has a sophisticated thermoregulation system that employs negative feedback mechanisms to maintain an optimal core temperature. When the core temperature drops, peripheral and central thermoreceptors send signals to the hypothalamus, activating the heat-promoting center. This center triggers several responses aimed at increasing the core temperature. First, vasoconstriction reduces the flow of warm blood from internal organs to the skin so that the heat is not lost from the skin,...

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Updated: Feb 2, 2026

Nerve Ultrasound Protocol to Detect Dysimmune Neuropathies

Nerve Ultrasound Protocol to Detect Dysimmune Neuropathies

Published on: October 7, 2021

Thermoregulation in neuropathies.

Robert D Fealey¹

¹Department of Neurology, Mayo Clinic, Rochester, MN, United States.

Handbook of Clinical Neurology

|November 22, 2018

Summary

This summary is machine-generated.

Peripheral neuropathy can impair body temperature regulation. Abnormal thermoregulatory sweat tests (TST) in some patients indicate a higher risk of dangerous core temperature changes during heat exposure.

Keywords:

autonomic and behavioral thermoregulation small-fiber neuropathy thermoeffectors thermoregulatory sweat test vasomotor and sudomotor testing

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Corneal Confocal Microscopy: A Novel Non-invasive Technique to Quantify Small Fibre Pathology in Peripheral Neuropathies

Corneal Confocal Microscopy: A Novel Non-invasive Technique to Quantify Small Fibre Pathology in Peripheral Neuropathies

Published on: January 3, 2011

Area of Science:

Neurology
Autonomic Neuroscience
Dermatology

Background:

Peripheral neuropathy impacting autonomic and small sensory fibers can disrupt autonomic and behavioral thermoregulation.
Quantitative neurophysiologic tests and nerve fiber density assessments may identify individuals at risk for impaired thermoregulation.
Thermoregulatory sweating abnormalities are a key concern in neuropathy patients.

Purpose of the Study:

To investigate the relationship between thermoregulatory sweating impairment and core body temperature changes in neuropathy patients.
To identify specific patient subgroups with a higher risk of dysregulated thermoregulation.

Main Methods:

Analysis of 516 neuropathy patients undergoing thermoregulatory sweat testing (TST).
Quantification of anhidrosis percentage (TST%) and total body sweat rate.
Measurement of core temperature rise (slope) during controlled heating challenges.
Comparison of patients with normal TST versus those with abnormal TST, including a subset with TST% ≥ 25%.

Main Results:

345 out of 516 neuropathy patients (67%) exhibited TST abnormalities, with a mean anterior body surface anhidrosis (TST%) of 12%.
Patients with abnormal TST showed reduced total body sweat rate but no significant difference in core temperature rise slope compared to those with normal TST.
A subset of patients with TST% ≥ 25% demonstrated a significantly faster core temperature rise (lower slope) during heating.

Conclusions:

Thermoregulatory sweating impairment is common in peripheral neuropathy.
A significant subset of neuropathy patients with extensive anhidrosis (TST% ≥ 25%) are at increased risk for rapid core temperature elevation.
Etiologies in severe cases include diabetes, erythromelalgia, immune-mediated autonomic neuropathy, amyloidosis, and degenerative autonomic disorders.