When Jake was just five months old, he suffered a tonic-clonic attack for the first time. The tiny body of this five-month-old infant first stiffened and he started jerking rapidly. His mother, Stephanie Smith, says, “It was extremely hot that day. He was feeling extremely hot. From what we saw, we felt that we would not have seen a more horrific scene in our lives. But unfortunately it was not so.”
Jake started having such attacks repeatedly in hot weather. As soon as the humid, hot summer days arrived, the whole family started making arrangements to keep his body cool. When Jake was 18 months old, a genetic test conducted at that time revealed that he had a neurological disease called Dravet syndrome. Dravet syndrome also includes an epilepsy that affects one child out of every 15,000. It can cause epileptic seizures as well as impaired mental development and many other problems, such as autism, ADHD, problems related to speech, walking, eating and sleeping. Heat or sudden changes in temperature can trigger epileptic seizures.
Neurological effects of heatwaves
Jake is now 13 years old, but his mother says that he starts having seizures as soon as the weather changes. Smith says, “Continuously increasing heat and heatwaves are making this already serious disease even more difficult.” Sanjay Sisodia of University College London is an expert on climate change and its effect on the brain. He says that Dravet syndrome is just one example. There are many such neurological diseases which get worse with increasing temperatures.
Sisodia, an epilepsy specialist, says that he has often heard from the families of patients that their problems increase during heatwaves. He says, “After hearing such things, I thought that when so many brain processes are involved in dealing with heat, then why would climate change not affect the brain?” When Sisodia started reading research papers on this, he found out that epilepsy, stroke, encephalitis, multiple sclerosis, migraine and many other neurological diseases are worsened by heat and humidity. He found that the effect of climate change has started showing on our brain.
For example, about seven percent of the additional deaths during the 2003 European heatwave were directly related to neurological problems. Similar figures also came out in the 2022 UK heatwave. But heat does not just increase diseases. It can also affect our behavior. For example, it can make us more irritable, angry or depressed. So as the world gets hotter due to climate change, we need to understand what impact this will have on our brain.
Keeping the brain cool is a big challenge for the body
The temperature of the human brain, on average, is rarely more than one degree Celsius above our core body temperature. But our brain is one of the body’s most energy-intensive organs. The brain generates a lot of heat itself as we think, remember and react to the world around us.
This means that our body has to work hard to keep the brain cool. Blood circulation, which occurs through a network of veins, helps remove this excess heat and maintain a balanced brain temperature. This is important because our brain cells are very sensitive to temperature. In addition, some molecules that transmit messages between these cells are also considered temperature-dependent.
That is, if the brain becomes too hot or too cold, they cannot function properly. “We don’t yet fully understand how different parts of the brain are affected by heat. But we can think of it like a clock where all the parts are not working properly together,” says Sanjay Sisodia. Although extreme heat affects brain function in all people, it can impair our decision-making ability or make us take more risks. People with existing neurological diseases are most affected.
“Thermoregulation is a function of the brain itself, and if some parts of the brain are not working properly, this system can go awry. For example, in some types of multiple sclerosis, the core temperature of the body changes,” he explains. “Also, some drugs used to treat neurological and mental diseases, such as schizophrenia drugs, affect body temperature control,” he explains. This makes people on these drugs more vulnerable to heatstroke (hyperthermia in medical terms) and increases the risk of death due to heat.
Link between heat and neurological diseases
Evidence also suggests that people with dementia are at increased risk of hospitalisation and death during heatwaves. One reason for this may be age. The elderly have a reduced ability to regulate their body temperature, but their ability to think and understand also plays a role. This makes them less likely to take necessary precautions such as drinking enough water, closing windows or not going out in the sun.
Rising temperatures may also be linked to an increase in the number of strokes (brain attacks) and deaths from them. One study looked at stroke death data in 25 countries. On average, two additional deaths for every thousand stroke deaths occurred on the hottest days. Bethan Davis, a specialist in geriatrics at University Hospital Sussex (UK), says, “When we look at the fact that around 7 million people die of stroke each year worldwide, heat may cause more than ten thousand additional deaths each year.”
Bethan Davis’ team has warned that climate change may worsen this situation in the coming years. The team says that the burden of heat-related stroke will fall most heavily on middle and low-income countries, which are already most affected by climate change. These countries also have the highest incidence of stroke. A hotter world is also harming the mental development of the youngest children.
Jane Hurst, professor of women’s health at Imperial College London, says, “There has been a link between extreme heat and problems such as preterm birth.” A recent scientific review found that heatwaves increase the risk of preterm birth by 26 percent. This can delay mental development in children, as well as reduce their intellectual ability. Hurst says, “However, there is still a lot that we do not know.”
Extreme heat due to climate change can also put additional burden on our brain. This can lead to neurodegenerative diseases, such as Alzheimer’s or Parkinson’s.
Heat also affects the protective wall of the brain, which normally protects the brain from toxins, bacteria and viruses. When this barrier weakens, harmful elements can easily reach the brain. Experts say that as the temperature increases, the number of mosquitoes will also increase, which can spread viruses like Zika, chikungunya and dengue. These can also cause neurological diseases.
Medical entomologist Tobias Zuter of the Swiss Tropical and Public Health Institute says, “Zika virus can affect the fetus and cause problems like microcephaly.” He says, “Due to rising temperatures and shorter winters, mosquito breeding season starts earlier and lasts longer.”
‘The era of global warming is over, now is the era of global boiling’ The effect of heat can vary from person to person. Some people feel better in hot weather, while for others it can be extremely uncomfortable. Sisodia says, “There can be many reasons behind different sensitivity and one of them can be genetic predisposition.” He says, “The effects that we are seeing today in people suffering from neurological diseases can also be seen in those who are currently healthy in the future. As climate change increases, such effects may be seen in the future.”
Heatwaves can affect the brain at many levels. However, scientists are still trying to understand how rising temperatures affect our brain and whether maximum temperature has the greatest impact.
Questions are also how long the period of heatwave can affect the brain? Are night temperatures more dangerous? Who are at greater risk? This information will help us develop strategies that can protect the most vulnerable people from heat. These strategies may include the restoration of a heatwave early warning system. An insurance scheme can also be created to compensate workers who are unable to do daily wages due to heat.
When July 2023 was declared the hottest month ever, UN Secretary-General Antonio Guterres had said, “The era of global warming is over, now the era of global boiling has begun.” It cannot be denied that climate change has arrived and it is increasing rapidly. In such a situation, concern has also started about the ‘hot brain’.
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