Cerebrovascular Reactivity Following Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2024 · DOI: 10.46292/sci23-00068 · Published: July 1, 2024

Spinal Cord Injury Neurology Medical Imaging

Simple Explanation

Spinal cord injuries (SCI) can lead to cardiovascular problems, increasing the risk of stroke and cognitive issues. This study used fMRI to measure how blood vessels in the brain react to changes in carbon dioxide levels in people with SCI compared to those without injuries. The study found that it takes longer for blood vessels in the brain to respond to these changes in people with SCI. This slower response might explain why people with SCI have a higher risk of cerebrovascular health problems. The research also suggested that the longer someone has had an SCI, the lower their diastolic blood pressure, and the more frequent their hypotensive episodes, the poorer their cerebrovascular reactivity outcomes may be.

Study Duration

Data collected between June 2018 and February 2020

Participants

n = 8 with SCI, n = 6 controls

Evidence Level

Not specified

Key Findings

1
Participants with SCI showed a longer CVR component (tau) in the grey matter compared to controls, indicating a slower response time in brain blood vessel reactivity.
2
Time since injury (TSI) was negatively correlated with steady-state CVR in the grey matter and brainstem of SCI participants, suggesting that longer TSI is associated with poorer CVR outcomes.
3
Lower steady-state CVR in the brainstem of the SCI group correlated with lower diastolic blood pressure, indicating a potential link between blood pressure and cerebrovascular health in individuals with SCI.

Research Summary

This study investigated cerebrovascular reactivity (CVR) in individuals with spinal cord injury (SCI) compared to noninjured controls using functional magnetic resonance imaging (fMRI) during a hypercapnic challenge. The findings suggest a difference in the dynamic CVR component (tau) between the SCI and noninjured control groups, potentially explaining the higher cerebrovascular health burden in SCI individuals. Exploratory associations indicate that longer time since injury (TSI), lower diastolic blood pressure, and more hypotensive episodes may lead to poorer CVR outcomes, warranting further research to establish causality.

Practical Implications

Cerebrovascular Health Monitoring

Regular monitoring of cerebrovascular reactivity (CVR) should be considered for individuals with SCI, especially those with longer time since injury, to identify and manage potential cerebrovascular health risks.

Blood Pressure Management

Targeted interventions to manage blood pressure, particularly preventing hypotensive episodes, may help improve or maintain CVR and potentially reduce the risk of cerebrovascular complications in SCI.

Rehabilitation Therapies Development

The development of new rehabilitation therapies aimed at improving CVR and cerebrovascular health in individuals with SCI should be explored, potentially focusing on interventions that address hypotension and improve vascular function.

Study Limitations

1
Small sample size of both SCI and noninjured control participants.
2
Data analyzed were solely from male participants, limiting generalizability to females with SCI.
3
Lack of blood pressure measurements during fMRI acquisition.

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