FIGURE 1.

Schematic representation (created with BioRender.com) of the thermoregulation mechanism in the human body. Intracellular mitochondria play a critical role in generating energy (in the form of ATP) and heat, which is sufficient for a cell’s sustenance (52). Healthy cellular mitochondria in the brain, liver, and skeletal muscle mass contribute as much as 63% of the body heat (58). When heat production and heat loss are balanced, human body homeostasis is maintained. However, when heat production is insufficient to compensate heat loss, which occurs via conduction, convection, radiation, or evaporation, the human body is likely to be susceptible to cold (85, 86). For a given thermal stimuli, such as cold wind, the thermoreceptors which are free nerve endings in the skin and other organs will send a signal to the hypothalamus to activate the heat-regulating center (87). Consequently, several responses, such as lowering of skin temperature, shivering of skeletal muscle to produce more heat, and vasoconstriction to prevent heat loss, will take place (35). Therefore, individuals with CP usually experience cold sensations in their hands or feet, have a pale face, and seek a warmer environment.