The effects of aging on the distribution of cerebral blood flow with postural changes and mild hyperthermia.

PURPOSE: Cerebral blood flow (CBF) would be impaired with dual stresses of heat and orthostatic changes, even if those stresses are mild, in the elderly with declined cardio- and cerebrovascular functions with aging. To test the hypothesis, we compared the response of blood flow in the internal carotid artery (ICA) and vertebral artery (VA) to dual stresses of heat and orthostatic changes between the elderly and young individuals. METHODS: Nine elderly and eight young healthy men (71.3 ± 3.0 and 23.3 ± 3.1 years, mean ± SD, respectively) underwent measurements of blood flow in the ICA, VA and external carotid artery (ECA) via ultrasonography. The measurements were obtained in sitting and supine positions under normothermic (NT) and mildly hyperthermic (HT) conditions (ambient temperature 28 °C). Esophageal temperatures increased from NT (36.4 ± 0.2 °C, mean ± SE) to HT (37.4 ± 0.2 °C) with lower legs immersion in 42 °C water. RESULTS: With heat stress, ECA blood flow increased in both postures in both age groups (effect of heat, p < 0.001), whereas ICA blood flow remained unchanged. With postural changes from supine to sitting, ECA blood flow remained unchanged whereas ICA blood flow decreased (effect of posture, p = 0.027) by 18% in NT in the young and by 20% in HT in the elderly. VA blood flow remained unchanged under both heat stress and postural changes. CONCLUSIONS: The CBF is impaired under dual stresses of heat and orthostatic changes in healthy aged individuals, even if the levels of the stresses are mild.

Effects of skin surface cooling before exercise on lactate accumulation in cool environment.

PURPOSE: We assessed whether plasma lactate accumulation increased and the lactate threshold (LT) declined when the skin temperature was lowered by whole body skin surface cooling before exercise in cool, but not temperate, conditions, and whether the lowered LT was associated with sympathetic activation or lowered plasma volume (PV) by cold-induced diuresis. METHODS: Ten healthy subjects performed a graded maximal cycling exercise after pre-conditioning under three different conditions for 60 min. Ambient temperature (using an artificial climatic chamber) and water temperature in a water-perfusion suit controlled at 25 and 34 °C in temperate-neutral (Temp-Neut); 25 and 10 °C in temperate-cool (Temp-Cool); and at 10 and 10 °C in cool-cool (Cool-Cool) conditions, respectively. Esophageal (Tes) and skin temperatures were measured; plasma lactate ([Lac]p) and noradrenaline concentrations ([Norad]p), and relative change in PV (%ΔPV) were determined before and after pre-conditioning and during exercise, and LT was determined. RESULTS: After pre-conditioning, Tes was not different among trials, whereas the mean skin temperature was lower in Cool-Cool and Temp-Cool than in Temp-Neut (P < 0.001). During exercise, [Lac]p and [Norad]p were higher (P = 0.009 and P < 0.001, respectively) and LT was lower (P = 0.013) in Cool-Cool than in the other trials. The %ΔPV was not different among trials. LT was correlated with [Norad]p during exercise (R = 0.50, P = 0.005). CONCLUSIONS: Whole body skin surface cooling before exercise increases lactate accumulation and decreases LT with sympathetic activation when exercise is performed in a cool, but not in a temperate, environment.

Thermal sensation during mild hyperthermia is modulated by acute postural change in humans.

Thermal sensation represents the primary stimulus for behavioral and autonomic thermoregulation. We assessed whether the sensation of skin and core temperatures for the driving force of behavioral thermoregulation was modified by postural change from the supine (Sup) to sitting (Sit) during mild hyperthermia. Seventeen healthy young men underwent measurements of noticeable increase and decrease (±0.1 °C/s) of skin temperature (thresholds of warm and cold sensation on the skin, 6.25 cm2 of area) at the forearm and chest and of the whole-body warm sensation in the Sup and Sit during normothermia (NT; esophageal temperature (Tes), ∼36.6 °C) and mild hyperthermia (HT; Tes, ∼37.2 °C; lower legs immersion in 42 °C of water). The threshold for cold sensation on the skin at chest was lower during HT than NT in the Sit (P < 0.05) but not in Sup, and at the forearm was lower during HT than NT in the Sup and further in Sit (both, P < 0.05), with interactive effects of temperature (NT vs. HT) × posture (Sup vs. Sit) (chest, P = 0.08; forearm, P < 0.05). The threshold for warm sensation on the skin at both sites remained unchanged with changes in body posture or temperature. The whole-body warm sensation was higher during HT than NT in both postures and higher in the Sit than Sup during both NT and HT (all, P < 0.05). Thus, thermal sensation during mild hyperthermia is modulated by postural change from supine to sitting to sense lesser cold on the skin and more whole-body warmth.

Forced respiration during the deeper water immersion causes the greater inspiratory muscle fatigue in healthy young men.

[Purpose] The purpose of the present study was to evaluate the effect of water immersion at different water depths on respiratory function and the effect of inspiratory load breathing (ILB) during water immersion at different water depths on respiratory muscle strength evaluated by maximum inspiratory and expiratory pressures (PImax and PEmax, respectively). [Subjects] Eight healthy men participated randomly in three trials. [Methods] All sessions were conducted with the participants in a sitting position immersed in a water bath. We evaluated respiratory function, PImax and PEmax during submersion at three different levels of water depth (umbilicus; 4th-rib; or clavicle, CL) and after subsequent 15-min ILB. [Results] Decreases in vital capacity and expiratory reserve volume from baseline by water immersion were significantly greater in the CL trial than those in the other trials. In the CL trial, PImax was immediately reduced after ILB compared to that at baseline, and the reduction was significantly greater than those in the other trials. PEmax was not affected by ILB in any of the trials. [Conclusion] Forced respiration during deeper water immersion caused greater inspiratory muscle fatigue in healthy young men.

Lower thermal sensation in normothermic and mildly hyperthermic older adults.

PURPOSE: It is important to know how thermal sensation is affected by normal aging under conditions that elevate core body temperature for the prevention of heat-related illness in older people. We assessed whether thermal sensation under conditions of normothermia (NT) and mild hyperthermia (HT) is lowered in older adults. METHODS: Seventeen younger (23 ±  3 years) and 12 older (71 ±  3 years) healthy men underwent measurements of the cold and warmth detection thresholds ( ± 0.1 °C/s) of their chest and forearm skin, and whole body warmth perception under NT (esophageal temperature, T es, ~36.5 °C) and HT (T es, ~37.3 °C; lower legs immersed in 42 °C water) conditions. RESULTS: Warmth detection threshold at the forearm was increased in older compared with younger participants under both NT (P = 0.006) and HT (P = 0.004) conditions. In contrast, cold detection threshold at the forearm was decreased in older compared with younger participants under NT (P = 0.001) but not HT (P = 0.16). Mild hyperthermia decreased cold detection threshold at forearm in younger participants (P = 0.001) only. There were no effects of age and condition on warmth and cold detection thresholds at chest. Whole body warmth perception increased during HT compared with NT in both groups (both, P < 0.001), and older participants had lower values than the younger group under NT (P = 0.001) and HT (P = 0.051). CONCLUSIONS: Skin warmth detection thresholds at forearm and whole body warmth perception under NT and HT and skin cold detection thresholds at forearm under NT deteriorated with aging.

Treadmill walking in water induces greater respiratory muscle fatigue than treadmill walking on land in healthy young men.

The purpose of the present study was to investigate the effect of walking in water on respiratory muscle fatigue compared with that of walking on land at the same exercise intensity. Ten healthy males participated in 40-min treadmill walking trials on land and in water at an intensity of 60% of peak oxygen consumption. Respiratory function and respiratory muscle strength were evaluated before and after walking trials. Inspiratory muscle strength and forced expiratory volume in 1 s were significantly decreased immediately after walking in water, and expiratory muscle strength was significantly decreased immediately and 5 min after walking in water compared with the baseline. The decreases of inspiratory and expiratory muscle strength were significantly greater compared with that after walking on land. In conclusion, greater inspiratory and expiratory muscle fatigue was induced by walking in water than by walking on land at the same exercise intensity in healthy young men.

The effect of cognitive-motor dual-task training on cognitive function and plasma amyloid ß peptide 42/40 ratio in healthy elderly persons: a randomized controlled trial.

BACKGROUND: Physical activity reduces the incidence and progression of cognitive impairment. Cognitive-motor dual-task training, which requires dividing attention between cognitive tasks and exercise, may improve various cognitive domains; therefore, we examined the effect of dual-task training on the executive functions and on plasma amyloid ß peptide (Aß) 42/40 ratio, a potent biomarker of Alzheimer's disease, in healthy elderly people. METHODS: Twenty-seven sedentary elderly people participated in a 12-week randomized, controlled trial. The subjects assigned to the dual-task training (DT) group underwent a specific cognitive-motor dual-task training, and then the clinical outcomes, including cognitive functions by the Modified Mini-Mental State (3MS) examination and the Trail-Making Test (TMT), and the plasma Aß 42/40 ratio following the intervention were compared with those of the control single-task training (ST) group by unpaired t-test. RESULTS: Among 27 participants, 25 completed the study. The total scores in the 3MS examination as well as the muscular strength of quadriceps were equally improved in both groups after the training. The specific cognitive domains, "registration & recall", "attention", "verbal fluency & understanding", and "visuospatial skills" were significantly improved only in the DT group. Higher scores in "attention", "verbal fluency & understanding", and "similarities" were found in the DT group than in the ST group at post-intervention. The absolute changes in the total (8.5 ± 1.6 vs 2.4 ± 0.9, p = 0.004, 95 % confidence interval (CI) 0.75-3.39) and in the scores of "attention" (1.9 ± 0.5 vs -0.2 ± 0.4, p = 0.004, 95 % CI 2.25-9.98) were greater in the DT group than in the ST group. We found no changes in the TMT results in either group. Plasma Aß 42/40 ratio decreased in both groups following the training (ST group: 0.63 ± 0.13 to 0.16 ± 0.03, p = 0.001; DT group: 0.60 ± 0.12 to 0.25 ± 0.06, p = 0.044), although the pre- and post-intervention values were not different between the groups for either measure. CONCLUSIONS: Cognitive-motor dual-task training was more beneficial than single-task training alone in improving broader domains of cognitive functions of elderly persons, and the improvement was not directly due to modulating Aß metabolism.

Thermoregulatory responses are attenuated after fructose but not glucose intake.

PURPOSE: We examined whether plasma hyperosmolality induced by oral monosaccharide intake attenuated thermoregulatory responses and whether the responses were different between fructose and glucose. METHODS: Ten healthy young subjects performed three trials in a sitting position in an artificial climate chamber (ambient temperature, 28°C; relative humidity, 40%). After resting for 10 min, the subjects drank 300 mL of water alone (control), or 300 mL of water supplemented with 75 g fructose or 75 g glucose. Twenty minutes later, they were heated passively by immersing the lower legs in water at 42°C for 60 min. Plasma osmolality (Posm), sodium ([Na+]p) and insulin concentrations ([Ins]p), and percent change in plasma volume (%ΔPV) were measured, and esophageal temperature (Tes) thresholds for cutaneous vasodilation (THCVC) and sweating (THSR) at the forearm were determined. RESULTS: Posm was significantly increased by fructose and glucose intake compared with water alone, although %ΔPV and [Na+]p were not significantly different among the three trials. [Ins]p was significantly higher after glucose intake than after fructose or water alone. THCVC and THSR were significantly higher after fructose intake than after glucose intake, which showed similar values to water intake. CONCLUSIONS: These results suggest that the Tes threshold for thermoregulation is elevated after fructose intake, indicating the attenuation of thermoregulatory responses, whereas it is not attenuated after glucose intake. These results provide a novel insight to better determine the carbohydrate component of oral rehydration fluids for preventing dehydration and/or heat disorders.

Oral administration of γ-aminobutyric acid affects heat production in a hot environment in resting humans.

BACKGROUND: Central administration of γ-amino butyric acid (GABA) induces lower body temperature in animals in hot ambient air. However, it is still unknown whether oral GABA administration affects temperature regulation at rest in a hot environment in humans. Therefore, in the present study, we specifically hypothesized that systemic administration of GABA in humans would induce hypothermia in a hot environment and that this response would be observed in association with decreased heat production. METHODS: Eight male participants drank a 200-ml sports drink with 1 g of GABA (trial G) or without GABA (trial C), then rested for 30 minutes in a sitting position in a hot environment (ambient air temperature 33°C, relative humidity 50%). RESULTS: We found that changes in esophageal temperature from before drinking the sports drink were lower in trial G than in trial C (-0.046 ± 0.079°C vs 0.001 ± 0.063°C; P < 0.05), with lower heat production calculated by oxygen consumption (41 ± 5 W/m2 vs 47 ± 8 W/m2; P < 0.05). CONCLUSIONS: In this study, we have demonstrated that a single oral administration of GABA induced a larger decrease in body core temperature compared to a control condition during rest in a hot environment and that this response was concomitant with a decrease in total heat production.

Lower skin temperature decreases maximal cycling performance.

BACKGROUND: It is known that external cooling of body regions involved in exercise, prior to exercise, decreases anaerobic performance. However, there have been no studies reporting the effects of whole body skin surface cooling before exercise on maximal anaerobic capacity. In order to clarify the effects, we compared power output during the Wingate anaerobic test between preconditioning by exposure to temperature 10 degrees C and 25 degrees C. METHODS: Eight healthy males carried out the Wingate test for 30 seconds, after pre-conditioning for 60 minutes using a perfusion suit with water at a temperature of 10 degrees C or 25 degrees C. We evaluated the peak power (PP) and peak power slope (PS) of the power output. RESULTS: Mean skin temperature (T(sk)) at 60 minutes of pre-conditioning in the 10 degrees C trial was significantly lower than in the 25 degrees C trial (p < 0.05). PP and also PS were significantly lower in the 10 degrees C trial than in the 25 degrees C trial. Changes (Δ) in PP between the 10 degrees C trial and the 25 degrees C trial were strongly correlated with ΔT(sk) and Δ in thigh and leg skin temperature (ΔT(thigh) and ΔT(leg), respectively), whereas ΔPS was strongly correlated with ΔT(sk), but not with ΔT(thigh) and ΔT(leg). CONCLUSIONS: Whole body skin surface cooling prior to exercise restricts anaerobic capacity, especially in the initial phase of exercise.

Effect of oral administration of GABA on temperature regulation in humans during rest and exercise at high ambient temperature.

BACKGROUND: Centric administration of gamma-aminobutyric acid (GABA) has been implicated to affect temperature regulation in animals during rest or under anesthesia. However, there are few reports concerning the effects of the oral administration of GABA on temperature regulation in humans during rest and exercise. In order to clarify the effects and underlying mechanisms, we measured several parameters related to temperature regulation of humans during rest and exercise at high ambient temperature (35 degrees C). METHODS: On two occasions, eight endurance-trained men rested for 20 min and cycled at 65% VO2peak for 30 min. In control trial (trial-C), subjects drank the sample which was a sports drink of 200 mL (placebo) before the rest period. In another trial (trial-G), subjects drank the sample which was a sports drink containing 1000 mg of GABA (GABA drink) before the rest period. RESULTS: In trial-G, the plasma GABA concentrations were maintained higher than those in trial-C during the experiment. An increase of esophageal temperature during rest and exercise was inhibited in trial-G. Sweat rate, and plasma catecholamine concentrations during exercise were inhibited in trial-G. CONCLUSIONS: Esophageal temperature inhibition is suggested to be induced by the suppression of cold-sensitive neurons during rest, and the inhibition of plasma catecholamine concentrations caused by the GABA-induced attenuation of the sympathetic nervous system during exercise.

Lateral canthal support system in Japanese.

The present study aimed to elucidate microscopically the precise structure of the generally termed 'lateral canthal tendon' (LCT). Specimens from 9 post-mortem lower eyelids of 6 Japanese aged from 72 to 91 years old at death were fixed in 10% buffered formalin, and microscopically examined. Specimens were excised as exenterated samples including an area 5 mm wider than the orbital aperture. The removed contents were further incised longitudinally on the central eyelid and also incised parallel to the upper eyelid margin on the site 3 mm from its margin. After the preparation of microscopical examination, sections of all 9 eyelids were stained with Hematoxylin and Eosin. We found that the structure generally termed LCT consisted of two definitive different layers microscopically. The superficial layer was only an orbital septum (septal band). It was mainly constituted of thick fibers between adipose-rich tissues. The deep layer continued from the tarsus and projected posteriorly; which was a ligament (tarsoligamentous band). This tissue was constituted by thin, minute fibers with little adipose tissues. The structure generally termed LCT is not a tendon but a complex constitution of an orbital septum and a ligament; which we named, in a mass, 'lateral canthal bands', cooperatively supporting the lateral canthus.

Myoneural junctions of extraocular muscles: distances from the orbital rim and widths.

PURPOSE: To examine both the distances from the orbital rim to the myoneural junctions (MNJs) and the widths of the MNJs of all extraocular muscles. METHODS: Six orbits of 3 post-mortem cadavers were used. The cadavers (1 female and 2 males) were all Japanese with an average age of 76.3 years. The MNJs of the extraocular muscles and their motor nerves were exposed, and then the distance from the orbital rim to each MNJ and the width of each MNJ were examined. RESULTS: The distance from the orbital rim to each MNJ in the 6 extraocular muscles ranged from 24.4 to 33.6 mm and the width of each MNJ ranged from 5.0 to 8.5 mm. CONCLUSIONS: It is essential for orbital surgeons to understand both the distance from the orbital rim to MNJs and the widths of MNJs. This information not only aids the understanding of MNJ damage, but also prevents iatrogenic nerve impairment during orbital surgery.

Fibrous connective tissue between Müller's muscle and the palpebral conjunctiva as a reinforcement structure and a natural barrier for the upper eyelid.

This study was performed to illustrate and discuss the significance of fibrous connective tissue between the Müller's muscle and the palpebral conjunctiva. Nine upper eyelids of 6 Oriental cadavers were microscopically examined; ages at death ranged from 72 to 91 years. Tissue of the posterior lamella of the upper eyelid was removed without the orbital septum and orbital fat. Removed eyelids were incised perpendicularly at the center of the eyelid. After pretreatment, sliced sections were stained with Hematoxylin and Eosin and examined microscopically. A thick fibrous connective tissue was found to exist between the Müller's muscle and the palpebral conjunctiva. The connective tissue continued proximally to the intermuscular transverse ligament and was distally attached to the posterior site of the upper aspect of the tarsus. All cases showed infiltration of lymphocytes from the conjunctiva; however, these were completely blocked by the fibrous connective tissue and never reached Müller's muscle. This connective tissue supports eyelid traction and is a natural barrier for the Muller's muscle against conjunctivitis.

The medial canthal tendon is composed of anterior and posterior lobes in Japanese eyes and fixes the eyelid complementarily with Horner's muscle.

PURPOSE: To report that the medial canthal tendon (MCT) is not simply the aggregate of the orbicularis oculi muscle (OOM) and its tendon. METHODS: Twenty eyelids of 10 cadavers were used. The cadavers, seven male and three female, were all Japanese, with an average age of death of 76.2 years. The relationship between the MCT and the OOM, and between the tarsus and Horner's muscle were investigated. Histological findings were obtained with hematoxylin and eosin staining. RESULTS: The MCT was structured with an anterior lobe, the tendon from the tarsal area of the OOM, and a posterior lobe, the muscle-tendon transition area in the orbital area of the OOM. The nasal aspect of the tarsus was fixed by Horner's muscle. CONCLUSIONS: The MCT and Horner's muscle are located in an important area of the eyelid; therefore, it is essential to understand their precise anatomy.

No raphe identified in the orbicularis oculi muscle.

This study was performed to elucidate whether the raphe of the orbicularis oculi muscle (raphe) exists or not. Nine upper eyelids of 6 Oriental cadavers with ages at death ranging from 72 to 91 years were dissected; 6 for gross dissections and 3 for histological slice sections. After removing the lateral half of the eyelid skin, the lateral part of the orbicularis oculi muscle and its subjacent tissue were observed macroscopically. The full layered tissue of the 8 mm lateral part from the orbital rim was incised perpendicularly and sections sliced, which were then observed microscopically after staining with the hematoxylin and eosin. The raphe was not identified macroscopically or microscopically. The lateral part of the orbicularis oculi muscle was continuous without the tendinous intercalation; under it, fibrous connective tissue corresponding to the lateral orbital thickening was observed, and in which the band configuration, microscopically the tendinous structure, was formed. The raphe was not identified. The physiological role of the lateral part of the orbicularis oculi muscle is maintained by a less tight attachment of the lateral orbital thickening, but not by the raphe.

Three ligaments reinforce the lower eyelid.

This study was performed to elucidate the ligamentous structures in the lower eyelid other than the Lockwood ligament. Ten lower eyelids (right 5, left 5) of 5 Oriental post-mortems were dissected. The orbital septum was incised along the orbital rim, and then turned over toward the eyelid margin. The orbital fat was exposed and removed as much as possible without injuring the ligamentous structures. The ligamentous structures in the lower eyelid were then investigated macroscopically. There were two other ligaments in the lower eyelid in addition to the Lockwood ligament. All three ligaments originated from the posterior lacrimal crest, but went in different directions. The superior ligament ran on the junction of the orbital septum and the capsulopalpebral fascia, and in the lateral area, it ran on the posterior aspect of the orbital septum and attached to the periosteum of the lateral orbital rim. The inferior ligament went toward the posterior aspect of the inferior oblique muscle after separating from the Lockwood ligament. Ligaments other than the Lockwood ligament were revealed in the lower eyelid. These ligaments are thought to reinforce the fragility of the lower eyelid.