Analysis of autonomic responses during transnasal cooling via facial temperature and heart rate monitoring

Introduction Transnasal cooling has been shown to improve symptoms in patients with migraine headaches in a recent clinical trial. However, the mechanism underlying this phenomenon is unclear. Methods We sought to explore the potential autonomic responses to transnasal cooling in 10 patients by measuring changes in facial temperature and heart rate. Results We observed a decrease in average facial temperatures at the end of intervention compared to baseline in all regions measured, namely the forehead (−0.55 ± 0.58°F, p = 0.007), the opposite cheek (−0.44 ± 0.34°F, p = 0.027), and the same cheek (−0.64 ± 0.91°F, p = 0.001). The average baseline heart rate was 70.1 ± 10.5 bpm and did not undergo a change throughout the three phases (p = 0.22). Conclusion Bilateral facial temperature reduction despite unilateral cooling, prolonged cooling effect post-intervention, and no significant change in heart rate suggest a local sympathetic response to transnasal cooling.