Modeling the mechanisms of Uhthoff's phenomenon in MS patients with internuclear ophthalmoparesis

Internuclear ophthalmoparesis (INO) is the most common saccadic eye movement disorder observed in patients with multiple sclerosis (MS). It is characterized by slowing of the adducting eye during horizontal saccades, and most commonly results from a demyelinating lesion in the medial longitudinal fasciculus (MLF) within the midline tegmentum of the pons (ventral to the fourth ventricle) or midbrain (ventral to the cerebral aqueduct). Recent research has demonstrated that adduction velocity in MS-related INO, as measured by infrared eye movement recording techniques, is further reduced by a systematic increase in core body temperature (utilizing tube-lined water infusion suits in conjunction with an ingestible temperature probe and transabdominal telemetry) and reversed to baseline with active cooling. These results suggest that INO may represent a model syndrome by which we can carefully study the Uhthoff's phenomenon and objectively test therapeutic agents for its prevention.