Noninvasive neuroprosthesis promotes cardiovascular recovery after spinal cord injury

Rahul Sachdeva, Tom E. Nightingale, Kiran Pawar, Tamila Kalimullina, Adam Mesa, Arshdeep Marwaha, Alison M.M Williams, Tania Lam, Andrei Krassioukov

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Abstract

Spinal cord injury (SCI) leads to severe impairment in cardiovascular control, commonly manifested as a rapid, uncontrolled rise in blood pressure triggered by peripheral stimuli—a condition called autonomic dysreflexia. The objective was to demonstrate 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, we show that TCS not only prevents the instigation of autonomic dysreflexia, but also mitigates its severity when delivered during an already-triggered episode. Furthermore, when TCS was delivered as a multisession therapy for 6 weeks post-SCI, the severity of autonomic dysreflexia was significantly reduced when tested in the absence of concurrent TCS. This treatment effect persisted for at least 1 week after the end of therapy. More importantly, we demonstrate the clinical applicability of TCS in treatment of autonomic dysreflexia in an individual with cervical, motor-complete, chronic SCI. We anticipate that TCS will offer significant therapeutic advantages, such as obviating the need for surgery resulting in reduced risk and medical expenses. Furthermore, this study provides a framework for testing the potential of TCS in improving recovery of other autonomic functions such lower urinary tract, bowel, and sexual dysfunction following SCI.
Original languageEnglish
Pages (from-to)1244-1256
JournalNeurotherapeutics
Volume18
Issue number2
Early online date31 Mar 2021
DOIs
Publication statusE-pub ahead of print - 31 Mar 2021

Keywords

  • Autonomic dysreflexia
  • Blood pressure
  • Cardiovascular dysfunction
  • Noninvasive neuromodulation
  • Spinal cord injuries
  • Transcutaneous stimulation

ASJC Scopus subject areas

  • Pharmacology
  • Clinical Neurology
  • Pharmacology (medical)

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