Gregory W. McGarr

Oxidative fuel selection and shivering thermogenesis during a 12- and 24-h cold-survival simulation

Because the majority of cold exposure studies are constrained to short-term durations of several hours, the long-term metabolic demands of cold exposure, such as during survival situations, remain largely unknown. The present study provides the first estimates of thermogenic rate, oxidative fuel selection, and muscle recruitment during a 24-h cold-survival simulation. Using combined indirect calorimetry and electrophysiological and isotopic methods, changes in muscle glycogen, total carbohydrate, lipid, protein oxidation, muscle recruitment, and whole body thermogenic rate were determined in underfed and noncold-acclimatized men during a simulated accidental exposure to 7.5 °C for 12 to 24 h. In noncold-acclimatized healthy men, cold exposure induced a decrease of ∼0.8 °C in core temperature and a decrease of ∼6.1 °C in mean skin temperature (range, 5.4-6.9 °C). Results showed that total heat production increased by approximately 1.3- to 1.5-fold in the cold and remained constant throughout cold exposure. Interestingly, this constant rise in Ḣprod and shivering intensity was accompanied by a large modification in fuel selection that occurred between 6 and 12 h; total carbohydrate oxidation decreased by 2.4-fold, and lipid oxidation doubled progressively from baseline to 24 h. Clearly, such changes in fuel selection dramatically reduces the utilization of limited muscle glycogen reserves, thus extending the predicted time to muscle glycogen depletion to as much as 15 days rather than the previous estimates of approximately 30-40 h. Further research is needed to determine whether this would also be the case under different nutritional and/or colder conditions.

Spectral analysis of reflex cutaneous vasodilatation during passive heat stress

Previous work has demonstrated that spectral analysis is a useful tool to non-invasively ascertain the mechanisms of control of the cutaneous circulation. The majority of work using spectral analysis has focused on local control mechanisms, with none examining reflex control. Skin blood flow was analysed using spectral analysis on the dorsal aspect of the forearm of 7 males and 7 females during passive heat stress, with mean forearm and local temperature at the site of measurement maintained at thermoneutral (33°C) to minimize the effect of local control mechanisms. Participants were passively heated to ~1.2±0.1°C above baseline rectal temperature (d=4.0, P<0.001) using a water-perfused, tube lined suit, with skin blood flow assessed using a laser-Doppler probe with an integrated temperature monitor. Spectral analysis was performed using a Morlet wavelet on the entire data set, with median power extracted during 20min of data during baseline (normothermia) and hyperthermia. Passive heat stress significantly increased laser-Doppler flux above baseline (d=4.7, P<0.001). Spectral power of the endothelial nitric oxide-independent (0.005-0.01Hz; d=1.1, P=0.004), neurogenic (0.2-0.05Hz; d=0.6, P=0.025), myogenic (0.05-0.15Hz; d=1.5, P=0.002), respiratory (0.15-0.4Hz; d=1.4 P=0.002), and cardiac (0.4-2.0Hz; d=1.1, P=0.012) frequency intervals increased with passive heat stress. In contrast, the endothelial nitric oxide-dependent frequency interval did not change (0.01-0.02Hz; d=0.3, P=0.09) with passive heat stress. These data suggest that cutaneous reflex vasodilatation is neurogenic in origin and not mediated by endothelial-nitric oxide synthase, and are congruent with invasive examinations of reflex cutaneous vasodilatation.

Investigating the roles of core and local temperature on forearm skin blood flow

We sought to isolate the contributions of core and local temperature on forearm skin blood flow (SkBF), and to examine the interaction between local- and reflexive-mechanisms of SkBF control. Forearm SkBF was assessed using laser-Doppler flowmetry in eight males and eight females during normothermia and hyperthermia (+1.2°C rectal temperature). Mean experimental forearm temperature was manipulated in four, 5min blocks between neutral (A: 33.0°C) and warm (B: 38.5°C) in an A-B-A-B fashion during normothermia, and B-A-B-A during hyperthermia. Mean control forearm skin temperature was maintained at ~33°C. Finally, local heating to 44°C was performed on both forearms to elicit maximal SkBF. Data are presented as a percentage of maximal cutaneous vascular conductance (CVC), calculated as laser-Doppler flux divided by mean arterial pressure. No sex differences were observed in any CVC measures (P>0.05). During normothermia, increasing experimental forearm temperature to 38.5°C elevated CVC by 42±8%max (d=3.1, P<0.001). Subsequently decreasing experimental forearm temperature back down to 33.0°C reduced CVC by 36±7%max (d=2.5, P<0.001). Finally, the second increase in experimental forearm temperature to 38.5°C increased CVC by 25±6%max (d=1.9, P<0.0001). During hyperthermia, decreasing experimental forearm temperature to 33.0°C reduced CVC by 6±1%max (d=0.5, P<0.001). Increasing experimental forearm temperature to 38.5°C increased CVC by 4±2%max (d=0.4, P<0.001). Finally, decreasing experimental forearm temperature to 33.0°C reduced CVC by 8±2%max (d=0.7, P<0.001). Compared to normothermia, CVC responses to local temperature changes during hyperthermia were almost abolished (normothermia: d=1.9-3.1; hyperthermia: d=0.4-0.7). These data indicate that local temperature drives SkBF during normothermia, while reflexive mechanisms regulate SkBF during hyperthermia.

Neither Short-term Sprint nor Endurance Training Enhances Thermal Response to Exercise in a Hot Environment

Improvements in fitness from a brief period of physical training may elicit sufficient physiological adaptations to decrease thermal strain during exercise in the heat. This study tested heat adaptation from short-term endurance (ET) and sprint-interval (SIT) training in moderately fit individuals. The ET group (n = 8) cycled at 65% for 8 sessions (4 sessions each at 60 and 90 min, respectively) over two weeks, while the SIT group (n = 8) performed repeated 30-s Wingate sprints (resistance 7.5% body mass; 4 sessions each of 4 and 5 sprints, respectively). and heat stress testing (HST; 60 min cycling at 65% at 35ºC, 40% relative humidity) were performed pre- and post-training. increased by 11% (p = 0.025) and 14% (p = 0.020) for the ET and SIT groups post-training, respectively. Thermal stress was similar pre- and post-training, with no significant difference in the rate of whole-body metabolic heat production (p = 0.106) for either group post-training. Cardiovascular improvement was evident with both ET and SIT, with a significant mean decrease (p = 0.014) in HR for both groups (ET: 146 ± 15 beats·min−1pre vs. 142 ± 12 beats·min−1post; SIT: 149 ± 15 beats·min−1pre vs. 146 ± 12 beats·min−1post) during the HST post-training. However, mean sweat loss (p = 0.248) and the rise in core temperature (p = 0. 260) did not change significantly comparing pre- and post-training HST. While short-term ET and SIT both induced significant improvements in aerobic fitness and decreased cardiovascular strain, neither elicited improved thermal responses during exercise in the heat and do not replace heat acclimatization.

The contribution of sensory nerves to the onset threshold for cutaneous vasodilatation during gradual local skin heating of the forearm and leg.

During local skin heating, the temporal onset of vasodilatation is delayed in the leg compared to the forearm, and sensory nerve blockade abolishes these differences. However, previous work using rapid skin heating did not allow for determination of sensory nerve influences on temperature thresholds for vasodilatation. Two sites were examined on both the forearm and leg, one control (CTRL), and one treated for sensory nerve blockade (EMLA). Skin blood flux was monitored using laser-Doppler probes, with heaters controlling local skin temperature (Tloc). Tloc was increased from 32-44 °C (+1 °C·10 min(-1)). Stimulus-response curves were constructed by fitting a four-parameter logistic function. EMLA significantly increased Tloc onset in the forearm (CTRL=35.3 ± 0.4 °C; EMLA=36.8 ± 0.7 °C) and leg (CTRL=36.5 ± 0.4 °C; EMLA=38.4 ± 0.5 °C; both P<0.05). At both CTRL and EMLA, Tloc onset was higher in the leg compared to the forearm (both P<0.05). In the forearm, median effective temperature to elicit 50% vasodilatation (ET50) was similar between sites (CTRL=39.7 ± 0.3 °C; EMLA=40.2 ± 0.4 °C; P=0.09); however, in the leg, EMLA significantly increased ET50 (CTRL=40.2 ± 0.3 °C; EMLA=41.0 ± 0.3 °C)(P<0.05). At CTRL sites, no limb difference was observed for ET50 (P=0.06); however, with EMLA, ET50 was significantly higher in the leg (P<0.05). EMLA significantly increased the gain of the slope at the forearm, (CTRL=0.31 ± 0.01%CVCmax·°C(-1); EMLA=0.45 ± 0.07%CVCmax·°C(-1)), and leg (CTRL=0.37 ± 0.05%CVCmax·°C(-1); EMLA=0.54 ± 0.04%CVCmax·°C(-1))(both P<0.05). At CTRL sites, the gain was significantly higher in the leg (P<0.05); however, for EMLA, no significant limb difference existed (P=0.10). These data indicate that the onset of vasodilatation occurs at a lower temperature in the forearm than the legs, and sensory nerves play an important role in both limbs.

Ischemia-reperfusion injury alters skin microvascular responses to local heating of the index finger

BACKGROUND Ischemia-reperfusion (IR) injury impairs microcirculatory function by reducing nitric oxide (NO) bioavailability and increasing sympathetic tone. This study non-invasively examined the effects of acute upper limb IR injury on local thermal hyperemia (LTH) in glabrous and non-glabrous finger skin. MATERIALS AND METHODS In ten healthy males, LTH was examined twice (~7-10 d apart) for each skin type on the index finger using laser-Doppler flowmetry in a counterbalanced design with either 1) 20 min ischemia, followed by reperfusion (ISCH) or 2) time-matched control (SHAM). LTH tests were performed using a standard heating protocol (33-42 °C at 1 °C·20 s-1 + 20 min at 44 °C) and baseline, initial peak, nadir, delayed plateau and maximal heating phases were identified as well as vasodilatory onset time and time to initial peak. Cutaneous vasomotion was evaluated using spectral analysis and comparing absolute and normalized wavelet amplitudes between conditions for both skin types at baseline and during LTH. RESULTS In non-glabrous skin, IR injury delayed the vasodilatory onset of local heating by 27.4 [11.3, 43.4] s (p = 0.004) and attenuated cutaneous vasodilation during the initial peak and sustained heating by -44.5 [-73.0, -15.9] PU (p = 0.003) and -34.4 [-62.9, -5.8] PU (p = 0.020), respectively. Analysis of normalized wavelet amplitudes in non-glabrous skin identified impaired microvascular function at baseline via NO-dependent mechanisms (-3.64 [-7.22, -0.05] %, p = 0.047), and during LTH via respiratory influences (-2.83 [-5.39, -0.21] %, p = 0.031). In glabrous skin, IR injury delayed vasodilatory onset time by 24.9 [1.1, 67.6] s (p = 0.042). The vasodilatory response to sustained local skin heating in glabrous skin was increased following IR injury (+56.3 [15.1, 116.5], p = 0.012), however, this was not evident when accounting for differences in blood pressure between conditions. Additionally, no other differences in vasodilatory or vasomotor functions were observed in this skin type between conditions (all, p > 0.05). CONCLUSIONS The current IR model elicits impaired cutaneous vasodilatory responses to local heating in young males, primarily in non-glabrous skin, and may be useful for exploring mechanisms of IR-injury and for testing potential countermeasures in otherwise healthy humans.

Between-day reliability of local thermal hyperaemia in the forearm and index finger using single point laser-Doppler flowmetry

To assess between‐day reliability for LTH in glabrous and nonglabrous index finger skin and nonglabrous forearm skin, with single‐point laser Doppler flowmetry.

An adjustable stabilizing device for imaging the cutaneous microcirculation with Sidestream Dark Field imaging

The recent development of hand-held videomicroscopy systems, such as the MicroScan, has provided a useful alternative to traditional capillaroscopy for direct in vivo imaging of the cutaneous microcirculation. Their small size and portability provide greater potential for imaging different areas of the skin under a variety of clinical and experimental conditions. To counteract the issues of movement and pressure artifacts associated with these systems, we developed an adaptable stabilization device for use in conjunction with the MicroScan imaging unit. The design presented here is simple yet effective, and the basic platform can be replicated by others or modified to suit particular clinical or experimental needs or for use with other hand-held microscopy systems.

Cognitive Performance during a 24-Hour Cold Exposure Survival Simulation

Survivor of a ship ground in polar regions may have to wait more than five days before being rescued. Therefore, the purpose of this study was to explore cognitive performance during prolonged cold exposure. Core temperature (T c) and cognitive test battery (CTB) performance data were collected from eight participants during 24 hours of cold exposure (7.5°C ambient air temperature). Participants (recruited from those who have regular occupational exposure to cold) were instructed that they could freely engage in minimal exercise that was perceived to maintaining a tolerable level of thermal comfort. Despite the active engagement, test conditions were sufficient to significantly decrease T c after exposure and to eliminate the typical 0.5–1.0°C circadian rise and drop in core temperature throughout a 24 h cycle. Results showed minimal changes in CTB performance regardless of exposure time. Based on the results, it is recommended that survivors who are waiting for rescue should be encouraged to engage in mild physical activity, which could have the benefit of maintaining metabolic heat production, improve motivation, and act as a distractor from cold discomfort. This recommendation should be taken into consideration during future research and when considering guidelines for mandatory survival equipment regarding cognitive performance.

The contribution of sensory nerves to cutaneous vasodilatation of the forearm and leg to local skin warming

Purpose The initial cutaneous vasodilatory response to local skin heating is larger in the forearm than the leg. While the initial vasodilatation of the forearm to local heating is primarily dependent on sensory nerves, their role in the leg is unknown. We compared the contribution of sensory nerves in driving the cutaneous vasodilatory response of the forearm and leg to local heating using local anaesthetic (EMLA) cream.