Normalization of Blood Pressure With Spinal Cord Epidural Stimulation After Severe Spinal Cord Injury

Front. Hum. Neurosci., 2018 · DOI: 10.3389/fnhum.2018.00083 · Published: March 8, 2018

Spinal Cord Injury Cardiovascular Science Neurology

Simple Explanation

Individuals with spinal cord injury (SCI) often experience chronic low blood pressure and orthostatic hypotension, which can negatively affect their health, rehabilitation, and quality of life. This study explores the use of targeted spinal cord epidural stimulation (scES) to improve cardiovascular function in individuals with severe SCI who suffer from chronic hypotension. The results show that stimulating the lumbosacral spinal cord can effectively and safely elevate blood pressures to normal ranges in humans with severe SCI, using individual-specific scES configurations.

Study Duration

2 weeks

Participants

4 research participants with chronic cervical SCI

Evidence Level

Not specified

Key Findings

1
CV-scES resulted in statistically significant increases in mean arterial pressure in all four research participants.
2
The increase in blood pressure was reproducible over five sessions within a 2-week period.
3
Each individual required a unique CV-scES configuration to consistently maintain normalized cardiovascular parameters.

Research Summary

The study investigated the effects of targeted spinal cord epidural stimulation (scES) on cardiovascular function in individuals with severe spinal cord injury (SCI) who suffer from chronic hypotension. Four research participants with chronic cervical SCI received an implant of a 16-electrode array on the dura (L1–S1 cord segments, T11–L1 vertebrae). The results demonstrated that stimulating the dorsal lumbosacral spinal cord can effectively and safely elevate blood pressures to normal ranges from a chronic hypotensive state in humans with severe SCI with individual-specific CV-scES.

Practical Implications

Potential Treatment for Hypotension

CV-scES provides a potential unique treatment option for SCI patients to normalize blood pressure and alleviate the adverse impacts of chronic low blood pressure and orthostatic hypotension.

Improved Quality of Life

Normalization of blood pressure can improve physical, emotional, and social well-being for individuals with SCI.

Insights into Spinal Circuitry

The study provides insights into the infrastructure and capacity for plasticity of the human spinal circuitry.

Study Limitations

1
Limited to four individuals
2
Needs to be repeated in a larger number of people with chronic SCI over longer periods of time
3
Further analyses of mechanisms focused on heart rate and blood pressure variability and post-stimulation effects are needed

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