An Autonomic Neuroprosthesis: Noninvasive Electrical Spinal Cord Stimulation Restores Autonomic Cardiovascular Function in Individuals with Spinal Cord Injury

Aaron A. Phillips, Jordan W. Squair, Dimitry G. Sayenko, V. Reggie Edgerton, Yury Gerasimenko, Andrei V. Krassioukov

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Despite autonomic dysfunction after spinal cord injury (SCI) being the major cause of death and a top health priority, the clinical management options for these conditions are limited to drugs with delayed onset and nonpharmacological interventions with equivocal effectiveness. We tested the capacity of electrical stimulation, applied transcutaneously over the spinal cord, to manage autonomic dysfunction in the form of orthostatic hypotension after SCI. We assessed beat-by-beat blood pressure (BP), stroke volume, and cardiac contractility (dP/dt; Finometer), as well as cerebral blood flow (transcranial Doppler) in 5 individuals with motor-complete SCI (4 cervical, 1 thoracic) during an orthostatic challenge with and without transcutaneous electrical stimulation applied at the TVII level. During the orthostatic challenge, all individuals experienced hypotension characterized by a 37 ± 4 mm Hg decrease in systolic BP, a 52 ± 10% reduction in cardiac contractility, and a 23 ± 6% reduction in cerebral blood flow (all p < 0.05), along with severe self-reported symptoms. Electrical stimulation completely normalized BP, cardiac contractility, cerebral blood flow, and abrogated all symptoms. Noninvasive transcutaneous electrical spinal cord stimulation may be a viable therapy for restoring autonomic cardiovascular control after SCI.

Original languageEnglish (US)
Pages (from-to)446-451
Number of pages6
JournalJournal of Neurotrauma
Volume35
Issue number3
DOIs
StatePublished - Feb 1 2018

Keywords

  • autonomic
  • cardiovascular
  • neurological injury
  • spinal cord
  • spinal cord injury
  • stimulation

ASJC Scopus subject areas

  • Clinical Neurology

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