Temperature Sensitivity a Biomarker for MS Disease Progression

Temperature sensitivity may be a biomarker of disease progression in multiple sclerosis (MS), according to study results presented at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) Congress 2025, held in Barcelona, Spain from September 24 to 26, 2025.

Patients with MS often report worsened neurological symptoms due to heat (Uhthoff’s) or cold (reverse-Uhthoff’s), which negatively affects quality of life. A study conducted by researchers at the Dell Medical School included 102 patients with MS who provided serum and plasma samples and completed a questionnaire on disease characteristics, temperature sensitivity, and the effects of heat and cold stimuli.

The prevalence of Uhthoff’s was 67%, while 27% experienced reverse-Uhthoff’s. Heat exacerbated fatigue and muscle weakness, whereas cold worsened muscle stiffness and fatigue. Heat-induced symptoms could last from over an hour to up to a day for some patients.

A total of 32.5% of patients reported improvement in Uhthoff’s after initiating disease modifying therapy, while 25% reported improvements in reverse-Uhthoff’s. Patients with an older MS diagnosis and those with dysautonomia were more likely to report Uhthoff’s. Temperature sensitivity was also common among those with impaired sleep, fatigue, and chronic pain.

Uhthoff’s was associated with glial fibrillary acidic protein and neurofilament light chain levels.

The study authors concluded, “Our study is the first extensive investigation of prevalence and qualities of heat and cold sensitivity in MS. The association between MS duration, dysautonomia, and QoL metrics suggest that temperature sensitivity may serve as a valuable biomarker for disease progression in MS.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.