Soltesz Alexandra E, Zhao Fei, Wecht Jill M, Mateika Jason H, Panza Gino S
John D. Dingell Veterans Affairs Medical Center, Detroit, MI, United States.
Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, MI, United States.
Front Neurosci. 2025 Jul 22;19:1600772. doi: 10.3389/fnins.2025.1600772. eCollection 2025.
Persons with spinal cord injuries often suffer from autonomic dysfunction, sleep disordered breathing, and impaired mitochondrial capacity. Current treatment options for these individuals are limited and often have significant side effects. Thus, new interventions that target multiple physiological systems and circumvent physical limitations would be a significant development for persons with spinal cord injury (pwSCI). One potential intervention is daily mild intermittent hypoxia (MIH) which has been shown to improve blood pressure control and upper airway function during sleep. Four individuals with chronic motor incomplete SCI underwent 8 days of MIH (ClinicalTrials.Gov ID #NCT05351827, https://clinicaltrials.gov/study/NCT05351827). The MIH protocol was administered each morning during wakefulness with end-tidal oxygen maintained at 55-60 mmHg. End-tidal carbon dioxide was maintained at + 3 mmHg above baseline during the MIH. Autonomic dysfunction (autonomic dysreflexia and orthostatic hypotension), sleep quality, upper airway function, mitochondrial capacity, and microvascular function were tested before, the day after, and 2 weeks following the MIH protocol. Systolic autonomic dysreflexia improved by 46% ± 14% and orthostatic hypotension improved by 160% ± 63% after MIH. Reductions in the apnea hypopnea index were observed, alongside a concurrent reduction in arousals during sleep. Upper airway function improved and mitochondrial capacity increased following 8 days of MIH. These preliminary data from four participants in an ongoing clinical trial suggest that 8 days of MIH may improve autonomic dysfunction, sleep quality, and mitochondrial capacity in pwSCI. The recruitment of additional participants is required to support these preliminary findings.
https://clinicaltrials.gov/study/NCT05351827, identifier NCT05351827.
脊髓损伤患者常伴有自主神经功能障碍、睡眠呼吸紊乱和线粒体功能受损。目前针对这些患者的治疗选择有限，且往往有明显的副作用。因此，针对多个生理系统且能规避身体限制的新干预措施，对脊髓损伤患者（pwSCI）来说将是一项重大进展。一种潜在的干预措施是每日进行轻度间歇性低氧（MIH），已证明其可改善睡眠期间的血压控制和上呼吸道功能。四名慢性运动不完全性脊髓损伤患者接受了为期8天的MIH治疗（ClinicalTrials.Gov标识符#NCT05351827，https://clinicaltrials.gov/study/NCT05351827）。MIH方案在清醒状态下每天早晨实施，呼气末氧分压维持在55 - 60 mmHg。在MIH期间，呼气末二氧化碳分压维持在比基线高3 mmHg。在MIH方案实施前、实施后一天和实施后2周，对自主神经功能障碍（自主神经反射异常和体位性低血压）、睡眠质量、上呼吸道功能、线粒体功能和微血管功能进行了测试。MIH后，收缩期自主神经反射异常改善了46%±14%，体位性低血压改善了160%±63%。观察到呼吸暂停低通气指数降低，同时睡眠期间的觉醒次数也减少。经过8天的MIH治疗后，上呼吸道功能改善，线粒体功能增强。这项正在进行的临床试验中四名参与者的这些初步数据表明，8天的MIH治疗可能改善pwSCI患者的自主神经功能障碍、睡眠质量和线粒体功能。需要招募更多参与者来支持这些初步发现。
https://clinicaltrials.gov/study/NCT05351827，标识符NCT05351827。
