Infrared Thermal Analysis and Individual Differences in Skin Temperature Asymmetry in Rett Syndrome



      We evaluated the feasibility of using a portable infrared thermal camera to quantify the degree of thermal dysregulation (cold hands/feet) and test for naturally occurring within-patient skin temperature asymmetry in Rett syndrome.


      Infrared thermal images were acquired passively from 15 patients (mean age = 13.7 years, range 4-47) with clinical diagnoses of Rett. Images were acquired using a FLIR T400 infrared thermal camera (still images recorded at 5 Hz, resolution of 320 × 240 pixels, thermal sensitivity = 0.05°C; capture session lasted approximately 3 minutes). The infrared thermal camera was orthogonal to the body part (hands, feet) and positioned approximately 1 meter from the skin's surface.


      There were large intraindividual left/right differences in temperature. Seven (47%) and eight (53%) patients had statistically significant (P <0.05) left/right asymmetries between hands (mean difference = 0.87°C, standard deviation = 1.21) and feet (mean difference = 1.73°C, standard deviation = 3.03), respectively. Coders were reliable (intraclass correlations 0.97-0.99) on temperatures and selection of anatomical regions of interest.


      The degree of thermal asymmetry may reflect prolonged activity of the sympathetic nervous system and individual differences in sympathetic regulation. As clinical trials emerge and endpoints are considered, portable infrared thermal camera may provide one noninvasive means of evaluating changes in sympathetic regulation.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Pediatric Neurology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Uematus S.
        Thermographic imaging of cutaneous sensory segment in patients with peripheral injury: Skin-temperature stability between sides of the body.
        J Neurosurg. 1985; 62: 716-720
        • Naidu S.
        • Chatterjee S.
        • Murphy M.
        • Uematsu S.
        • Phillapart M.
        • Moser H.
        Rett syndrome: new observations.
        Brain Dev. 1987; 9: 525-528
        • Korpelainen J.T.
        • Sotaniemi K.A.
        • Myllyla V.V.
        Asymmetrical skin temperature in ischemic stroke.
        Stroke. 1995; 26: 1543-1547
        • Huygen F.J.
        • Niehof S.
        • Klein J.
        • Zijlstra F.J.
        Computer-assisted skin videothermography is a highly sensitive quality tool in the diagnosis and monitoring of complex regional pain syndrome type I.
        Eur J Appl Physiol. 2004; 91: 516-524
        • Suzuki Y.
        • Kobayashi M.
        • Kuwabara K.
        • et al.
        Skin temperature responses to cold stress in patients with severe motor and intellectual disabilities.
        Brain Dev. 2013; 35: 265-269
        • Svedberg L.E.
        • Stener-Victorin E.
        • Nordahl G.
        • Lundeberg T.
        Skin temperature in the extremities of healthy and neurologically impaired children.
        Eur J Paediatr Neurol. 2005; 9: 347-354
        • Zaproudina N.
        • Varmavuo V.
        • Airaksinen O.
        • Närhi M.
        Reproducibility of infrared thermography measurements in healthy individuals.
        Physiol Meas. 2008; 29: 515-524
        • Umansky R.
        • Watson J.S.
        • Colvin L.
        • et al.
        Hand preference, extant of laterality, and functional hand use in Rett syndrome.
        J Child Neurol. 2003; 18: 481-487
        • Hagberg B.H.
        • Romell M.
        Rett females: Patterns of characteristic side-asymmetric neuroimpairments at long-term follow-up.
        Neuropediatrics. 2002; 33: 324-326
        • Ring E.F.
        • Ammer K.
        Infrared thermal imaging in medicine.
        Physiol Meas. 2012; 33: R33-R46