The effect of selective head-neck cooling on physiological and cognitive functions in healthy volunteers

Kevin Jackson 1 , Rachael Rubin 1 , 2 , Nicole Van Hoeck 3 , Tommy Hauert 1 , Valentina Lana 1 ,  and Huan Wang 1 , 2
  • 1 Thermal Neuroscience Beckman Institute, University of Illinois, IL 61801, USA, Urbana
  • 2 Carle Foundation Hospital Urbana, , Il 61801, USA
  • 3 Psychological & Educational Sciences Vrije Universiteit Brussel, , Belgium


In general, brain temperatures are elevated during physical sporting activities; therefore, reducing brain temperature shortly after a sports-related concussion (SRC) could be a promising intervention technique. The main objective of this study was to examine the effects of head and neck cooling on physiological and cognitive function in normal healthy volunteers. Twelve healthy volunteers underwent two different sessions of combined head and neck cooling, one session with a cold pack and one session with a room temperature pack. Physiological measurements included: systolic/diastolic blood pressure, pulse oximetry, heart rate, and sublingual and tympanic temperature. Cognitive assessment included: processing speed, executive function, and working memory tasks. Physiological measurements were taken pre-, mid- and post-cooling, while cognitive assessments were done before and after cooling. The order of the sessions was randomized. There was a significant decrease in tympanic temperature across both sessions; however more cooling occurred when the cold pack was in the device. There was no significant decrease in sublingual temperature across either session. The observed heart rates, pulse oximetry, systolic and diastolic blood pressure during the sessions were all within range of a normal healthy adult. Cognitive assessment remained stable across each session for both pre- and post-cooling. We propose that optimizing brain temperature management after brain injury using head and neck cooling technology may represent a sensible, practical, and effective strategy to potentially enhance recovery and perhaps minimize the subsequent short and long term consequences from SRC.

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  • [1] Rutland-Brown W., Langlois J.A., Thomas K.E., Xi Y.L., Incidence of traumatic brain injury in the United States, 2003, J. Head Trauma Rehabil., 2006, 21, 544-548

  • [2] De Beaumont L., Lassonde M., Leclerc S., Théoret H., Long-term and cumulative effects of sports concussion on motor cortex inhibition, Neurosurgery, 2007, 61, 329-336, discussion 336-337

  • [3] De Beaumont L., Tremblay S., Henry L.C., Poirier J., Lassonde M., Théoret H., Motor system alterations in retired former athletes: the role of aging and concussion history, BMC Neurol., 2013, 13, 109

  • [4] DeKosky S.T., Ikonomovic M.D., Gandy S., Traumatic brain injury: football, warfare, and long-term effects, Minn. Med., 2010, 93, 46-47

  • [5] Peskind E.R., Brody D., Cernak I., McKee A., Ruff R.L., Military- and sports-related mild traumatic brain injury: clinical presentation, management, and long-term consequences, J. Clin. Psychiatry, 2013, 74, 180-188, quiz 188

  • [6] Schretlen D.J., Shapiro A.M., A quantitative review of the effects of traumatic brain injury on cognitive functioning, Int. Rev. Psychiatry, 2003, 15, 341-349

  • [7] Shultz S.R., Bao F., Omana V., Chiu C., Brown A., Cain D.P., Repeated mild lateral fluid percussion brain injury in the rat causes cumulative long-term behavioral impairments, neuroinflammation, and cortical loss in an animal model of repeated concussion, J. Neurotrauma, 2012, 29, 281-294

  • [8] Langlois J.A., Rutland-Brown W., Wald M.M., The epidemiology and impact of traumatic brain injury: a brief overview, J. Head Trauma Rehabil., 2006, 21, 375-378

  • [9] Thurman D.J., Alverson C., Dunn K.A., Guerrero J., Sniezek J.E., Traumatic brain injury in the United States: a public health perspective, J. Head Trauma Rehabil., 1999, 14, 602-615

  • [10] DeKosky S.T., Ikonomovic M.D., Gandy S., Traumatic brain injury - football, warfare, and long-term effects, N. Engl. J. Med., 2010, 363, 1293-1296

  • [11] Wang H., Olivero W., Lanzino G., Elkins W., Rose J., Honings D., et al., Rapid and selective cerebral hypothermia achieved using a cooling helmet, J. Neurosurg., 2004, 100, 272-277

  • [12] Wang H., Wang B., Jackson K., Miller C.M., Hasadsri L., Llano D., et al., A novel head-neck cooling device for concussion injury in contact sports, Transl. Neurosci., 2014, 6, 20-31

  • [13] Lee J.K., Koh A.C., Koh S.X., Liu G.J., Nio A.Q., Fan P.W., Neck cooling and cognitive performance following exercise-induced hyperthermia, Eur. J. Appl. Physiol., 2014, 114, 375-384

  • [14] Godek S.F., Bartolozzi A.R., Godek J.J., Sweat rate and fluid turnover in American football players compared with runners in a hot and humid environment, Br. J. Sports Med., 2005, 39, 205-211

  • [15] Godek S.F., Godek J.J., Bartolozzi A.R., Hydration status in college football players during consecutive days of twice-a-day preseason practices, Am. J. Sports Med., 2005, 33, 843-851

  • [16] Nybo L., Moller K., Volianitis S., Nielsen B., Secher N.H., Effects of hyperthermia on cerebral blood flow and metabolism during prolonged exercise in humans, J. Appl. Physiol., 2002, 93, 58-64

  • [17] Ozgünen K.T., Kurdak S.S., Maughan R.J., Zeren C., Korkmaz S., Yazici Z., et al., Effect of hot environmental conditions on physical activity patterns and temperature response of football players, Scand. J. Med. Sci. Sports, 2010, 20 (Suppl. 3), 140-147

  • [18] Bailes J.E., Petraglia A.L., Omalu B.I., Nauman E., Talavage T., Role of subconcussion in repetitive mild traumatic brain injury, J. Neurosurg., 2013, 119, 1235-1245

  • [19] Broglio S.P., Eckner J.T., Kutcher J.S., Field-based measures of head impacts in high school football athletes, Curr. Opin. Pediatr., 2012, 24, 702-708

  • [20] Broglio S.P., Eckner J.T., Martini D., Sosnoff J.J., Kutcher J.S., Randolph C., Cumulative head impact burden in high school football, J. Neurotrauma, 2011, 28, 2069-2078

  • [21] Broglio S.P., Eckner J.T., Paulson H.L., Kutcher J.S., Cognitive decline and aging: the role of concussive and subconcussive impacts, Exerc. Sport Sci. Rev., 2012, 40, 138-144

  • [22] Gavett B.E., Stern R.A., McKee A.C., Chronic traumatic encephalopathy: a potential late effect of sport-related concussive and subconcussive head trauma, Clin. Sports Med., 2011, 30, 179-188

  • [23] McCrory P., Sports concussion and the risk of chronic neurological impairment, Clin. J. Sport Med., 2011, 21, 6-12

  • [24] Sakurai A., Atkins C.M., Alonso O.F., Bramlett H.M., Dietrich W.D., Mild hyperthermia worsens the neuropathological damage associated with mild traumatic brain injury in rats, J. Neurotrauma, 2012, 29, 313-321

  • [25] Miyauchi T., Wei E.P., Povlishock J.T., Evidence for the therapeutic efficacy of either mild hypothermia or oxygen radical scavengers after repetitive mild traumatic brain injury, J. Neurotrauma, 2014, 31, 773-781

  • [26] Wilcox C.S., Effects of tempol and redox-cycling nitroxides in models of oxidative stress, Pharmacol. Ther., 2010, 126, 119-145

  • [27] Titus D.J., Furones C., Atkins C.M., Dietrich W.D., Emergence of cognitive deficits after mild traumatic brain injury due to hyperthermia, Exp. Neurol., 2015, 263, 254-262

  • [28] Rolls E.T., Tovee M.J., Processing speed in the cerebral cortex and the neurophysiology of visual masking, Proc. Biol. Sci., 1994, 257, 9-15

  • [29] Vendrell P., Junque C., Pujol J., Jurado M.A., Molet J., Grafman J., The role of prefrontal regions in the Stroop task, Neuropsychologia, 1995, 33, 341-352

  • [30] Owen A.M., McMillan K.M., Laird A.R., Bullmore E., N-back working memory paradigm: a meta-analysis of normative functional neuroimaging studies, Hum. Brain Mapp., 2005, 25, 46-59

  • [31] Covaciu L., Weis J., Bengtsson C., Allers M., Lunderquist A., Ahlström H., et al., Brain temperature in volunteers subjected to intranasal cooling, Intensive Care Med., 2011, 37, 1277-1284

  • [32] Georgiadis D., Schwarz S., Kollmar R., Schwab S., Endovascular cooling for moderate hypothermia in patients with acute stroke: first results of a novel approach, Stroke, 2001, 32, 2550-2553

  • [33] Hemmen T.M., Lyden P.D., Induced hypothermia for acute stroke, Stroke, 2007, 38, 794-799

  • [34] Kammersgaard L.P., Rasmussen B.H., Jørgensen H.S., Reith J., Weber U., Olsen T.S., Feasibility and safety of inducing modest hypothermia in awake patients with acute stroke through surface cooling: a casecontrol study: the Copenhagen Stroke Study, Stroke, 2000, 31, 2251- 2256

  • [35] De Beaumont L., Brisson B., Lassonde M., Jolicoeur P., Long-term electrophysiological changes in athletes with a history of multiple concussions, Brain Inj., 2007, 21, 631-644

  • [36] De Beaumont L., Fiocco A.J., Quesnel G., Lupien S., Poirier J., Altered declarative memory in introverted middle-aged adults carrying the BDNF val66met allele, Behav. Brain Res., 2013, 253, 152-156

  • [37] Lovell M., The management of sports-related concussion: current status and future trends, Clin. Sports Med., 2009, 28, 95-111

  • [38] Cubon V.A., Putukian M., Boyer C., Dettwiler A., A diffusion tensor imaging study on the white matter skeleton in individuals with sports-related concussion, J. Neurotrauma, 2011, 28, 189-201

  • [39] Slobounov S.M., Zhang K., Pennell D., Ray W., Johnson B., Sebastianelli W., Functional abnormalities in normally appearing athletes following mild traumatic brain injury: a functional MRI study, Exp. Brain Res., 2010, 202, 341-354

  • [40] Vagnozzi R., Signoretti S., Cristofori L., Alessandrini F., Floris R., Isgro E., et al., Assessment of metabolic brain damage and recovery following mild traumatic brain injury: a multicentre, proton magnetic resonance spectroscopic study in concussed patients, Brain, 2010, 133, 3232-3242

  • [41] Jeter C.B., Hergenroeder G.W., Hylin M.J., Redell J.B., Moore A.N., Dash P.K., Biomarkers for the diagnosis and prognosis of mild traumatic brain injury/concussion, J. Neurotrauma, 2013, 30, 657-670

  • [42] Allison M.A., Kang Y.S., Bolte J.H.4th, Maltese M.R., Arbogast K.B., Validation of a helmet-based system to measure head impact biomechanics in ice hockey, Med. Sci. Sports Exerc., 2014, 46, 115-123

  • [43] Beckwith J.G., Greenwald R.M., Chu J.J., Measuring head kinematics in football: correlation between the head impact telemetry system and Hybrid III headform, Ann. Biomed. Eng., 2012, 40, 237-248

  • [44] Mihalik J.P., McCaffrey M.A., Rivera E.M., Pardini J.E., Guskiewicz K.M., Collins M.W., et al., Effectiveness of mouthguards in reducing neurocognitive deficits following sports-related cerebral concussion, Dent. Traumatol., 2007, 23, 14-20

  • [45] Wang H., Wang B., Jackson K., Miller C.M., Hasadsri L., Llano D., et al., A novel head-neck cooling device for concussion injury in contact sports, Transl. Neurosci., 2015, 6, 20-31

  • [46] Kallmünzer B., Beck A., Schwab S., Kollmar R., Local head and neck cooling leads to hypothermia in healthy volunteers, Cerebrovasc. Dis., 2011, 32, 207-210

  • [47] Koehn J., Kollmar R., Cimpianu C.L., Kallmünzer B., Moeller S., Schwab S., et al., Head and neck cooling decreases tympanic and skin temperature, but significantly increases blood pressure, Stroke, 2012, 43, 2142-2148

  • [48] Kochanek P.M., Jackson T.C., It might be time to let cooler heads prevail after mild traumatic brain injury or concussion, Exp. Neurol., 2015, 267,13-17


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