Kirby Ana Karina, Pancholi Sidharth, Anderson Zada, Chesler Caroline, Everett Thomas H, Duerstock Bradley S
Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States.
Krannert Cardiovascular Research Center, Division of Cardiovascular Medicine, School of Medicine, Indiana University, Indianapolis, IN, United States.
Front Neurosci. 2023 Aug 28;17:1210815. doi: 10.3389/fnins.2023.1210815. eCollection 2023.
Autonomic dysreflexia (AD) affects about 70% of individuals with spinal cord injury (SCI) and can have severe consequences, including death if not promptly detected and managed. The current gold standard for AD detection involves continuous blood pressure monitoring, which can be inconvenient. Therefore, a non-invasive detection device would be valuable for rapid and continuous AD detection.
Implanted rodent models were used to analyze autonomic dysreflexia after spinal cord injury. Skin nerve activity (SKNA) features were extracted from ECG signals recorded non-invasively, using ECG electrodes. At the same time, blood pressure and ECG data sampled was collected using an implanted telemetry device. Heart rate variability (HRV) features were extracted from these ECG signals. SKNA and HRV parameters were analyzed in both the time and frequency domain.
We found that SKNA features showed an increase approximately 18 seconds before the typical rise in systolic blood pressure, indicating the onset of AD in a rat model with upper thoracic SCI. Additionally, low-frequency components of SKNA in the frequency domain were dominant during AD, suggesting their potential inclusion in an AD detection system for improved accuracy.
Utilizing SKNA measurements could enable early alerts to individuals with SCI, allowing timely intervention and mitigation of the adverse effects of AD, thereby enhancing their overall well-being and safety.
自主神经反射异常（AD）影响约70%的脊髓损伤（SCI）患者，若不及时发现和处理，可能会产生严重后果，包括死亡。目前AD检测的金标准是持续血压监测，但这可能不方便。因此，一种非侵入性检测设备对于快速、持续检测AD具有重要价值。
使用植入式啮齿动物模型分析脊髓损伤后的自主神经反射异常。使用心电图电极从无创记录的心电图信号中提取皮肤神经活动（SKNA）特征。同时，使用植入式遥测设备收集采样的血压和心电图数据。从这些心电图信号中提取心率变异性（HRV）特征。对SKNA和HRV参数进行时域和频域分析。
我们发现，在收缩压典型升高前约18秒，SKNA特征出现增加，这表明在胸段上脊髓损伤的大鼠模型中AD发作。此外，在AD期间，SKNA在频域中的低频成分占主导，这表明它们有可能纳入AD检测系统以提高准确性。
利用SKNA测量可以为SCI患者提供早期警报，以便及时干预并减轻AD的不良影响，从而提高他们的整体健康水平和安全性。
