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  4. Epidural Spinal Cord Stimulation of Lumbosacral Networks Modulates Arterial Blood Pressure in Individuals With Spinal Cord Injury-Induced Cardiovascular Deficits

Epidural Spinal Cord Stimulation of Lumbosacral Networks Modulates Arterial Blood Pressure in Individuals With Spinal Cord Injury-Induced Cardiovascular Deficits

Frontiers in Physiology, 2018 · DOI: 10.3389/fphys.2018.00565 · Published: May 18, 2018

Spinal Cord InjuryPhysiologyNeurology

Simple Explanation

Spinal cord injury often leads to low blood pressure and difficulty tolerating upright positions. This study explores whether epidural stimulation of the spinal cord can help regulate blood pressure in individuals with spinal cord injury. The study involved applying electrical stimulation to the lower spinal cord in individuals with spinal cord injuries and monitoring their blood pressure and muscle activity. The findings suggest that spinal cord stimulation can increase blood pressure in those with cardiovascular deficits due to spinal cord injury, potentially improving their ability to stand and participate in rehabilitation.

Study Duration
2009 to 2015
Participants
Seven males with chronic C5-T4 SCI
Evidence Level
Not specified

Key Findings

  • 1
    Spinal cord stimulation increased arterial blood pressure in individuals with SCI-induced cardiovascular deficits.
  • 2
    In participants without cardiovascular deficits, spinal cord stimulation did not induce significant increases in arterial blood pressure.
  • 3
    During standing assisted by spinal cord stimulation, blood pressure was maintained in individuals with cardiovascular deficits.

Research Summary

This study investigated the acute cardiovascular effects of lumbosacral spinal cord epidural stimulation (scES) configured to facilitate motor activity in persons with SCI. The results showed that scES increased arterial blood pressure in SCI individuals with detectable cardiovascular deficits but did not induce hypertension in those with normal blood pressure. The findings suggest that scES could be used to mitigate orthostatic intolerance and maintain blood pressure while standing in SCI individuals with cardiovascular dysregulation.

Practical Implications

Therapeutic Potential

Spinal cord stimulation may offer a new approach to manage unstable blood pressure in SCI patients undergoing physical rehabilitation.

Personalized Stimulation Parameters

Different stimulation parameters could be tailored to specifically activate autonomic structures and achieve more precise cardiovascular modulation.

Improved Rehabilitation Outcomes

By mitigating orthostatic intolerance and maintaining blood pressure, scES could enhance the ability of SCI patients to participate in and benefit from rehabilitation programs.

Study Limitations

  • 1
    Small sample size of seven individuals.
  • 2
    Variability in function due to injury not accounted for when grouping individuals by cardiovascular outcomes.
  • 3
    Need for more detailed investigation of mechanisms using larger sample size.

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