Thermoregulatory dysfunction in the chronic phase of cerebrovascular disease: Hypothalamus damage and behavior...

Impaired body temperature regulation can lead to severe medical consequences, including hypothermia and heatstroke. Despite its clinical significance and occurrence in individuals with cognitive impairment, this issue remains underexplored. This study investigates the underlying factors and neural basis of thermoregulatory dysfunction in individuals in the chronic phase of stroke.

We recruited 112 individuals with chronic cerebrovascular disease (M_age = 61.4 years, SD = 13.1; 75.9% male). Thermoregulatory dysfunction was assessed using rating scores provided by caregivers based on observed behaviors, while neuropsychological functioning was evaluated primarily through standardized objective measures. The relationship between thermoregulatory dysfunction and neuropsychological indices was assessed using simple linear regression, followed by multiple linear regression to adjust for potential confounders. To further examine the neuroanatomical basis, voxel-based lesion-behavior mapping was performed using MRIcron.

Multiple linear regression showed that thermoregulatory dysfunction was strongly associated with a hypothalamic lesion (effect size = 0.34), as well as deficits in behavioral control (0.50) and attention (0.22). Among subitems assessing behavioral control, lack of insight exhibited the strongest correlation with thermoregulatory dysfunction severity. Voxel-based lesion-behavior mapping suggested that the right dorsomedial hypothalamic lesion had the greatest impact, followed by lesions in the ventromedial and dorsomedial prefrontal areas; however, these findings did not reach statistical significance.

This study demonstrates that thermoregulatory dysfunction in the chronic phase of cerebrovascular disease is associated with both hypothalamic damage and deficits in behavioral control and attention. (PsycInfo Database Record (c) 2026 APA, all rights reserved).