Noninvasive Neuroprosthesis Promotes Cardiovascular Recovery After Spinal Cord Injury

Neurotherapeutics, 2021 · DOI: 10.1007/s13311-021-01034-5 · Published: March 31, 2021

Spinal Cord Injury Cardiovascular Science Neurology

Simple Explanation

Spinal cord injuries can cause problems with blood pressure control, leading to dangerous spikes. This study explores a non-surgical method to help manage this issue. The researchers used electrical stimulation on the skin to try and prevent or stop these blood pressure spikes in rats with spinal cord injuries. They also tested this method on one person with a spinal cord injury and found it helped control their blood pressure during a bowel routine.

Study Duration

6 weeks

Participants

43 adult male Wistar rats and 1 human participant with chronic SCI

Evidence Level

Pre-clinical evidence and a clinical case report

Key Findings

1
Acute TCS prevents and interrupts autonomic dysreflexia in rats with SCI.
2
Chronic TCS reduces the severity of autonomic dysreflexia and mitigates cardiac arrhythmias in rats.
3
TCS demonstrates clinical applicability by preventing/interrupting autonomic dysreflexia in an individual with chronic cervical SCI.

Research Summary

This study demonstrates the translational potential of noninvasive transcutaneous stimulation (TCS) in mitigating autonomic dysreflexia following SCI, using pre-clinical evidence and a clinical case report. In rats with SCI, TCS prevents the instigation of autonomic dysreflexia, mitigates its severity during triggered episodes, and reduces severity with multisession therapy. The clinical applicability of TCS in treating autonomic dysreflexia was demonstrated in an individual with cervical, motor-complete, chronic SCI.

Practical Implications

Therapeutic Advantages

TCS obviates the need for surgery, reducing risk and medical expenses.

Framework for Testing

The study provides a framework for testing TCS in improving recovery of other autonomic functions following SCI.

Clinical Significance

Alternate day TCS demonstrates similar efficacy as daily TCS, which could be clinically meaningful in reducing the required number of participants’ visits.

Study Limitations

1
Lack of detailed information on the type of cardiac arrhythmia observed during autonomic dysreflexia episodes.
2
Experimental autonomic dysreflexia in the human participant was conservatively performed in a controlled manner.
3
The efficacy of TCS to mitigate more severe episodes of autonomic dysreflexia is yet to be investigated.

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