The DOI matches its Crossref record; 218 of the 220 references it cites were found in a registry or an index.
The thermoregulation system and how it works
Abstract
Heat exchange processes between the body and the environment are introduced. The definition of the thermoneutral zone as the ambient temperature range within which body temperature (T b) regulation is achieved only by nonevaporative processes is explained. Thermoreceptors, thermoregulatory effectors (both physiologic and behavioral), and neural pathways and T b signals that connect receptors and effectors into a thermoregulation system are reviewed. A classification of thermoeffectors is proposed. A consensus concept is presented, according to which the thermoregulation system is organized as a dynamic federation of independent thermoeffector loops. While the activity of each effector is driven by a unique combination of deep (core) and superficial (shell) T b s, the regulated variable of the system can be viewed as a spatially distributed T b with a heavily represented core and a lightly represented shell. Core T b is the main feedback; it is always negative. Shell T b s (mostly of the hairy skin) represent the auxiliary feedback, which can be negative or positive, and which decreases the system's response time and load error. Signals from the glabrous (nonhairy) skin about the temperature of objects in the environment serve as feedforward signals for various behaviors. Physiologic effectors do not use feedforward signals. The system interacts with other homeostatic systems by "meshing" with their loops. Coordination between different thermoeffectors is achieved through the common controlled variable, T b. The term balance point (not set point) is used for a regulated level of T b. The term interthreshold zone is used for a T b range in which no effectors are activated. Thermoregulatory states are classified, based on whether: T b is increased (hyperthermia) or decreased (hypothermia); the interthreshold zone is narrow (homeothermic type of regulation) or wide (poikilothermic type); and the balance point is increased (fever) or decreased (anapyrexia). During fever, thermoregulation can be either homeothermic or poikilothermic; anapyrexia is always a poikilothermic state. The biologic significance of poikilothermic states is discussed. As an example of practical applications of the concept presented, thermopharmacology is reviewed. Thermopharmacology uses drugs to modulate specific temperature signals at the level of a thermoreceptor (transient receptor potential channel).
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“While neurons responsive to cold temperatures also exist, they are less common and generally activated indirectly by warmth-sensitive neurons, emphasizing the greater risks associated with overheating as opposed to overcooling (Romanovsky, 2018).”
From Comparative analysis of energy transfer mechanisms for neural implants (2024) · cites this paper as Romanovsky, 2018
In the citing paper
“Adding another layer of complexity are specialized neurons in the preoptic anterior hypothalamus (POA), which are central to the brain’s thermal sensitivity.”
From Comparative analysis of energy transfer mechanisms for neural implants (2024) · cites this paper as Romanovsky, 2018
In the citing paper
“These neurons play a key role in physiological responses to temperature changes as most of these neurons are sensitive to warmth, increasing their activity as temperature rises triggering further regulations (Romanovsky, 2018).”
From Comparative analysis of energy transfer mechanisms for neural implants (2024) · cites this paper as Romanovsky, 2018
In the citing paper
“Moreover, some molecules, such as transient receptor potential (TRP) channels like TRPM2, are known to act as heat sensors in hypothalamic neurons (Romanovsky, 2018).”
From Comparative analysis of energy transfer mechanisms for neural implants (2024) · cites this paper as Romanovsky, 2018
In the citing paper
“While neurons responsive to cold temperatures also exist, they are less common and generally activated indirectly by warmth-sensitive neurons, emphasizing the greater risks associated with overheating as opposed to overcooling (Romanovsky, 2018).”
From Comparative analysis of energy transfer mechanisms for neural implants (2024) · cites this paper as Romanovsky, 2018
In the citing paper
“Despite a biphasic rhythm in core body temperature being such a well-established and recognized feature of the ovulatory menstrual cycle, the neural pathways that link the female reproductive and thermoregulatory systems remain incompletely understood 5.”
From Temperature regulation in women: Effects of the menstrual cycle (2020) · cites this paper as [5]
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“As a vital physiological process, thermoregulation re fl ects the body ’ s ability to maintain homeostasis (Romanovsky, 2018; Tansey & Johnson, 2015).”
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Grenno, G., Piarulli, A., Alfì, G., Caruso, V., Aquino, G., Lencioni, R. A., Palagini, L., & Gemignani, A. (2026) · Current Sleep Medicine Reports · doi:10.1007/s40675-026-00380-0
“Recent conceptual frameworks thus reframe thermoregulation as a distributed ’balance-point‘ system rather than a fixed hypothalamic set-point, empha - sizing dynamic interactions among neural, metabolic, and circadian processes [54–56].”
Lilienfeldt, N., Tai, Y., Sun, H., Waddell, B., Yang, W., Branicky, R. S., & Hekimi, S. (2026) · Genetics · doi:10.1093/genetics/iyag157
“(iii) Temperature fluctuations are well documented to be experienced by the tissues of poikilotherms, heterotherms, and homeotherms, including humans (Tikuisis 2004; Taylor et al. 2014; Tansey and Johnson 2015; Martin and Falder 2017; Romanovsky 2018; Periard et al. 2021; Cramer et al. 2022).”
Аносов, А. А., Granovsky, N. V., Terekhov, I. I., Lebedenko, E. O., Erofeev, A. V., Popova, I. A., Shcherbakov, M. I., Nazarov, E. F., Беляев, Р. В., Mansfel’d, A. D., et al. (2026) · Acoustical Physics · doi:10.1134/s1063771026600075
Carrizo, M. C., Zenuto, R. R., & Cutrera, A. (2026) · Mammalian Biology · doi:10.1007/s42991-026-00608-0
Ghailassi, I. E., Razak, N. A. A., & Osman, N. A. A. (2026) · Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine · doi:10.1177/09544119261465864
“4 The result impacts both contact sensors (NTC thermis-tors) and non-contact sensors (infrared thermometers), but in slightly distinct ways.”
Periferakis, A., Troumpata, L., Periferakis, A.-T., Periferakis, K., Timofticiuc, I.-A., Georgatos-Garcia, S., Touriki, G., Bozatzi, A., Săvulescu-Fiedler, I., & Iftime, A. (2026) · Balneo and PRM Research Journal · doi:10.12680/balneo.2026.1019
de Korver, R., Kingma, B., Kenny, G. P., & Frijns, A. A. (2026) · Temperature · doi:10.1080/23328940.2026.2708582
Yang, T., Li, J., Wang, Z., Xiong, K., Wang, Y., Feng, L., Shan, F., & Huang, Q. (2026) · Neuroscience · doi:10.1016/j.neuroscience.2026.08.030
de Oliveira, M. K., Vilela, F. C., & Giusti‐Paiva, A. (2026) · Behavioural Brain Research · doi:10.1016/j.bbr.2026.116447
Vandendoren, M., Landen, J. G., Rogers, J. F., Killmer, S., Alamiri, B., Pohlman, C., Tattersall, G. J., Bedford, N. L., & Nelson, A. C. (2026) · eLife · doi:10.7554/elife.108212.3
Beyond Pain Intensity: A Patient-Informed Framework for Documenting Burden in Small Fiber Neuropathy
Hochman, G. (2026) · Neurology and Therapy · doi:10.1007/s40120-026-01063-2
The cutaneous vasculature: Development, repair, and disease
Wang, K., Quintana, J., Yang, V., Kawasumi, K., & Kam, C. Y. (2026) · Seminars in Cell and Developmental Biology · doi:10.1016/j.semcdb.2026.103704
Metadata
- Authors
- Romanovsky, A. A.
- Affiliations
- St. Joseph's Hospital and Medical Center (US)
- Corresponding author
- Andrej A. Romanovsky
- ORCID
- Andrej A. Romanovsky
- Venue
- Handbook of Clinical Neurology
- Publisher
- Elsevier
- Published
- 2018
- Volume
- 156
- Pages
- 3-43
- ISSN
- 0072-9752 (ISSN-L)
- OpenAlex
- W2901310937
- Cited by
- 186
- References
- 220
- Citations by year
- 2026: 24 · 2025: 31 · 2024: 32 · 2023: 18 · 2022: 25 · 2021: 30 · 2020: 20 · 2019: 6
- FWCI
- 46.46
- Type
- book chapter
- Language
- en
- Open access
- closed
- Locations
- Handbook of clinical neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Thermoregulation and physiological responses
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Thermal Regulation in Medicine
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Effects of Environmental Stressors on Livestock
- Keywords
- thermoregulation, thermoneutral zone, thermoreceptors, balance point, homeothermy, poikilothermy, fever, hyperthermia, hypothermia, TRP channels
- MeSH terms
- Animals, Body Temperature, Body Temperature Regulation, Humans, Neural Pathways, Feedback, Physiological
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