Manifestations of cold sensitivity - a case series

Area of Science:

• Medical Research
• Physiology
• Vascular Biology

Background:

• Cold sensitivity affects numerous individuals, impacting quality of life.
• The underlying pathophysiology of cold sensitivity remains incompletely understood.
• Current diagnostic methods may not fully capture the complexities of cold sensitivity.

Purpose of the Study:

• To investigate the utility of various methods in characterizing cold sensitivity.
• To explore the role of microvascular regulation in cold sensitivity.
• To evaluate physical examination, thermal quantitative sensory testing (QST), and laser speckle contrast analysis (LASCA) in diagnosing cold sensitivity.

Main Methods:

• A cohort of 12 participants (8 female, 4 male, ages 22-74) with cold sensitivity underwent assessment.
• Methods included semi-structured interviews, physical examinations, thermal QST for perception thresholds, and LASCA for skin perfusion.
• LASCA measured hand perfusion at baseline, after cold water immersion, and during rewarming.

Main Results:

• Physical examination and thermal QST provided minimal diagnostic information.
• Only 8% of subjects exhibited impaired thermal perception thresholds.
• LASCA revealed microvascular dysfunction, including absent proximal-distal perfusion gradients (50%) and dyshomogeneous perfusion (42%) at baseline.

Conclusions:

• Traditional methods like physical examination and thermal QST are insufficient for diagnosing cold sensitivity.
• Findings challenge a purely neurosensory pathophysiological hypothesis for cold sensitivity.
• LASCA demonstrates potential as a valuable tool for assessing microvascular regulation in cold sensitivity studies.