Patients with severe spinal cord injury often experience chronically low blood pressure. Spinal cord epidural stimulation could help safely and elevate it as well as chronic hypotension, researchers suggest.
“People with severe spinal cord injury—especially when it occurs in a higher level in the spine—have problems with blood pressure regulation to the point that it becomes the main factor affecting quality of life for them,” says Glenn Hirsch, MD.
“Some cannot even sit up without passing out. They are forced to use medications, compression stockings, or abdominal binders to maintain an adequate blood pressure,” adds Hirsch, professor of cardiology at the University of Louisville (UofL), in a media release from University of Louisville (UofL)
Hirsch, along with Susan Harkema, PhD, associate director of the Kentucky Spinal cord Injury Research Center at UofL, performed a study, published in Frontiers in Human Neuroscience, that included four participants with chronic, motor complete, cervical SCI who experienced persistent low resting blood pressure.
The participants were implanted with an electrode array for epidural stimulation, and individual configurations for stimulation were identified for each participant. During five 2-hour sessions, the participants’ blood pressure was elevated to normal ranges. Their blood pressure returned to low levels when stimulation ceased, and was again elevated to normal ranges with stimulation, according to the release.
Because of the undesirable side effects of pharmaceutical and non-pharmaceutical interventions, Hirsch states that epidural stimulation for chronic low blood pressure in SCI could have significant benefits.
“People with severe SCI who have problems with resting hypotension have limited options. This intervention appears to reliably and reproducibly maintain blood pressure,” Hirsch says, in the release.
Harkema, the publication’s first author, notes that their research is promising, but must be tested over time and with a larger cohort of study participants.
“We need to see if it will have an impact over months or years,” Harkema adds. “It will be very important to determine if these results are sustainable.”
UofL is screening participants for a 6-year study that will further explore the effects of epidural stimulation on people with spinal cord injury. That study will measure the extent to which epidural stimulation will improve cardiovascular function as well as facilitate the ability to stand and voluntarily control leg movements below the injury level in 36 participants with chronic, complete spinal cord injuries. Individuals interested in being considered for this study can add their information to the university’s Victory Over Paralysis database, the release notes.
[Source(s): University of Louisville, Science Daily]