# Hemodynamic responses of the prefrontal cortex following cold water immersion during an eyes-closed balance assessment

**Authors:** Cory Smith, Owen Salmon, Matt Segovia, Thomas Statz, Cierra Ugale, Rachel Rauth, Michael Mastrodicasa, Jaeho Shim

PMC · DOI: 10.1007/s00421-025-06027-2 · European Journal of Applied Physiology · 2025-10-23

## TL;DR

This study found that cold water immersion affects brain blood flow in the prefrontal cortex during balance tasks, possibly due to competing thermoregulatory demands.

## Contribution

The study reveals distinct cerebral hemodynamic patterns following cold water immersion during balance assessments.

## Key findings

- Cold water immersion caused a significant decrease in oxygenated hemoglobin and increase in deoxygenated hemoglobin in the prefrontal cortex.
- Thermoneutral water immersion did not significantly alter hemodynamic responses during balance assessments.
- Cerebral hemodynamic changes after cold exposure may reflect increased neural demand due to thermoregulation.

## Abstract

This study aimed to examine the impact of cold water immersion (CWI) on balance and the corresponding hemodynamic responses that occur within the prefrontal cortex (PFC). Measuring PFC activation during balance will identify cognitive mechanisms underlying postural control, which can be used to identify balance impairments or fall risk.

Twenty-three participants completed two separate testing visits consisting of a 10-min CWI at 15 °C and thermoneutral water immersion (TWI) at 35 °C. A 30-s eyes-closed balance assessment was performed pre- and post-exposure to identify changes in Path Length, Sway Range, and Sway Velocity. Oxygenated (O2Hb) and deoxygenated hemoglobin (HHb) were measured over the PFC using functional near-infrared spectroscopy during all balance assessments.

There were no detectable differences for Sex in any variable, nor significant differences in Path Length (p = 0.94), Sway Range (p = 0.92), and Sway Velocity (p = 0.81) between the CWI and TWI exposures. For the TWI, there were no differences in O2Hb (p = 0.15) or HHb (p = 0.28) between the pre- and post-exposure balance assessments. The CWI exposure resulted in a significant decrease in O2Hb (p ≤ 0.01) and an increase in HHb (p ≤ 0.01).

The demands of thermoregulation and balance maintenance following CWI resulted in distinct cerebral hemodynamic patterns which potentially reflected increased neural demand during the tasks. Increase in HHb and decrease in O2Hb suggest a unique response during the refractory period between the CWI and balance assessment that may reflect competing thermoregulatory processes associated with rewarming.

## Full-text entities

- **Diseases:** balance impairments (MESH:D060825)
- **Chemicals:** water (MESH:D014867), Oxygenated (-)

## Full text

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## Figures

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## References

1 references — full list in the complete paper: https://tomesphere.com/paper/PMC13013106/full.md

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Source: https://tomesphere.com/paper/PMC13013106