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经皮脊髓刺激映射用于血压反应的脊髓损伤神经调节:病例系列

Neuromodulation in Spinal Cord Injury Using Transcutaneous Spinal Stimulation-Mapping for a Blood Pressure Response: A Case Series.

作者信息

Engel-Haber Einat, Bheemreddy Akhil, Bayram Mehmed Bugrahan, Ravi Manikandan, Zhang Fan, Su Haiyan, Kirshblum Steven, Forrest Gail F

机构信息

Kessler Foundation, West Orange, New Jersey, USA.

Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

出版信息

Neurotrauma Rep. 2024 Sep 20;5(1):845-856. doi: 10.1089/neur.2024.0066. eCollection 2024.

Abstract

Spinal cord transcutaneous stimulation (scTS) offers a promising approach to enhance cardiovascular regulation in individuals with a high-level spinal cord injury (SCI), addressing the challenges of unstable blood pressure (BP) and the accompanying hypo- and hypertensive events. While scTS offers flexibility in stimulation locations, it also leads to significant variability and lack of validation in stimulation sites utilized by studies. Our study presents findings from a case series involving eight individuals with chronic cervical SCI, examining the hemodynamic effects of scTS applied in different vertebral locations, spanning from high cervical to sacral regions. Stimulation of the lumbosacral vertebrae region (L1/2, S1/2, and also including T11/12) significantly elevated BP, unlike cervical or upper thoracic stimulation. The observed trend, which remained consistent across different participants, highlights the promising role of lumbosacral stimulation in neuromodulating BP.

摘要

脊髓经皮刺激(scTS)为增强高位脊髓损伤(SCI)个体的心血管调节提供了一种有前景的方法,可应对血压(BP)不稳定以及随之而来的低血压和高血压事件等挑战。虽然scTS在刺激位置方面具有灵活性,但研究中使用的刺激部位也存在显著变异性且缺乏验证。我们的研究展示了一项涉及八名慢性颈髓损伤个体的病例系列研究结果,考察了在从高颈段到骶段不同椎体位置施加scTS的血流动力学效应。与颈部或上胸部刺激不同,刺激腰骶椎区域(L1/2、S1/2,也包括T11/12)可显著升高血压。在不同参与者中保持一致的观察趋势凸显了腰骶部刺激在神经调节血压方面的潜在作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee6a/11462428/cf25b51a67d4/neur.2024.0066_figure1.jpg

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