PMID- 29568266
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1662-5161 (Print)
IS  - 1662-5161 (Electronic)
IS  - 1662-5161 (Linking)
VI  - 12
DP  - 2018
TI  - Normalization of Blood Pressure With Spinal Cord Epidural Stimulation After 
      Severe Spinal Cord Injury.
PG  - 83
LID - 10.3389/fnhum.2018.00083 [doi]
LID - 83
AB  - Chronic low blood pressure and orthostatic hypotension remain challenging 
      clinical issues after severe spinal cord injury (SCI), affecting health, 
      rehabilitation, and quality of life. We previously reported that targeted 
      lumbosacral spinal cord epidural stimulation (scES) could promote stand and step 
      functions and restore voluntary movement in patients with chronic motor complete 
      SCI. This study addresses the effects of targeted scES for cardiovascular 
      function (CV-scES) in individuals with severe SCI who suffer from chronic 
      hypotension. We tested the hypothesis that CV-scES can increase resting blood 
      pressure and attenuate chronic hypotension in individuals with chronic cervical 
      SCI. 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). 
      Individual-specific CV-scES configurations (anode and cathode electrode 
      selection, voltage, frequency, and pulse width) were identified to maintain 
      systolic blood pressure within targeted normative ranges without skeletal muscle 
      activity of the lower extremities as assessed by electromyography. These 
      individuals completed five 2-h sessions using CV-scES in an upright, seated 
      position during measurement of blood pressure and heart rate. Noninvasive 
      continuous blood pressure was measured from a finger cuff by plethysmograph 
      technique. For each research participant there were statistically significant 
      increases in mean arterial pressure in response to CV-scES that was maintained 
      within normative ranges. This result was reproducible over the five sessions with 
      concomitant decreases or no changes in heart rate using individual-specific 
      CV-scES that was modulated with modest amplitude changes throughout the session. 
      Our study shows that stimulating dorsal lumbosacral spinal cord can effectively 
      and safely activate mechanisms to elevate blood pressures to normal ranges from a 
      chronic hypotensive state in humans with severe SCI with individual-specific 
      CV-scES.
FAU - Harkema, Susan J
AU  - Harkema SJ
AD  - Frazier Rehab Institute, Louisville, KY, United States.
AD  - Department of Neurological Surgery, Kentucky Spinal Cord Injury Research Center, 
      University of Louisville, Louisville, KY, United States.
FAU - Wang, Siqi
AU  - Wang S
AD  - Department of Neurological Surgery, Kentucky Spinal Cord Injury Research Center, 
      University of Louisville, Louisville, KY, United States.
FAU - Angeli, Claudia A
AU  - Angeli CA
AD  - Frazier Rehab Institute, Louisville, KY, United States.
AD  - Department of Neurological Surgery, Kentucky Spinal Cord Injury Research Center, 
      University of Louisville, Louisville, KY, United States.
FAU - Chen, Yangsheng
AU  - Chen Y
AD  - Department of Neurological Surgery, Kentucky Spinal Cord Injury Research Center, 
      University of Louisville, Louisville, KY, United States.
FAU - Boakye, Maxwell
AU  - Boakye M
AD  - Department of Neurosurgery, School of Medicine, University of Louisville, 
      Louisville, KY, United States.
FAU - Ugiliweneza, Beatrice
AU  - Ugiliweneza B
AD  - Department of Neurosurgery, School of Medicine, University of Louisville, 
      Louisville, KY, United States.
FAU - Hirsch, Glenn A
AU  - Hirsch GA
AD  - Division of Cardiology, Department of Medicine, University of Louisville School 
      of Medicine, Louisville, KY, United States.
LA  - eng
PT  - Journal Article
DEP - 20180308
PL  - Switzerland
TA  - Front Hum Neurosci
JT  - Frontiers in human neuroscience
JID - 101477954
PMC - PMC5852107
OTO - NOTNLM
OT  - cardiovascular system
OT  - epidural stimulation
OT  - heart rate
OT  - spinal cord injuries
OT  - systolic blood pressure
EDAT- 2018/03/24 06:00
MHDA- 2018/03/24 06:01
PMCR- 2018/01/01
CRDT- 2018/03/24 06:00
PHST- 2017/08/22 00:00 [received]
PHST- 2018/02/19 00:00 [accepted]
PHST- 2018/03/24 06:00 [entrez]
PHST- 2018/03/24 06:00 [pubmed]
PHST- 2018/03/24 06:01 [medline]
PHST- 2018/01/01 00:00 [pmc-release]
AID - 10.3389/fnhum.2018.00083 [doi]
PST - epublish
SO  - Front Hum Neurosci. 2018 Mar 8;12:83. doi: 10.3389/fnhum.2018.00083. eCollection 
      2018.