Review
Cell Biology
Kelsey E. Hudson, James W. Grau
Summary: The neurotransmitter GABA normally inhibits neural activity, but spinal cord injury can weaken this inhibitory effect. The change is linked to the increase in intracellular Cl- concentration, leading to over-excitation and the development of various neural disorders.
Article
Clinical Neurology
Rahul Sachdeva, Tom E. Nightingale, Kiran Pawar, Tamila Kalimullina, Adam Mesa, Arshdeep Marwaha, Alison M. M. Williams, Tania Lam, Andrei V. Krassioukov
Summary: The study demonstrates the effectiveness of transcutaneous stimulation in mitigating autonomic dysreflexia following spinal cord injury, both in prevention and reduction of severity; successful clinical application also provides hope for treating other autonomic dysfunctions after SCI.
Review
Medicine, General & Internal
Abanoub Aziz Rizk, Marina Saad, Mandeep Singh, Bernhard Schaller, Lashmi Venkatraghavan, Tumul Chowdhury
Summary: Quadriplegia patients undergoing surgery are prone to a variety of health complications, including autonomic dysreflexia, cardiac ischemia, and respiratory compromise. There is currently no clear consensus on the ideal anesthesia management technique for this patient population, and further research is needed to elucidate the exact mechanisms involved in perioperative complications.
FRONTIERS IN MEDICINE
(2022)
Review
Neurosciences
Nabila Brihmat, Didier Allexandre, Soha Saleh, Jian Zhong, Guang H. Yue, Gail F. Forrest
Summary: There is a growing interest in using non-invasive stimulation interventions, such as repetitive transcranial magnetic stimulation (rTMS), to improve functional outcomes and recovery after spinal cord injury (SCI). This scoping review focuses on the stimulation parameters used in 20 rTMS protocols and explores their potential associations with observed effects. Future studies should consider timing, intervention duration, and dosage in relation to the stage, level, and severity of the injury. More real vs. sham rTMS studies with similar designs and replication information are needed to establish a significant level of evidence for the use of rTMS in SCI.
FRONTIERS IN HUMAN NEUROSCIENCE
(2022)
Article
Clinical Neurology
Hiroyuki Mizuno, Fumiaki Honda, Hayato Ikota, Yuhei Yoshimoto
Summary: This case report describes a recurrent autonomic dysreflexia case associated with a cervical spinal cord tumor, presenting as paroxysmal hypertension and seizures. The patient underwent radiotherapy and died approximately 3 months after treatment initiation.
Article
Medicine, General & Internal
Soshi Samejima, Claire Shackleton, Raza N. Malik, Kawami Cao, Anibal Bohorquez, Tom E. Nightingale, Rahul Sachdeva, Andrei V. Krassioukov
Summary: Spinal cord injury (SCI) leads to severe cardiovascular dysfunction, and autonomic dysreflexia (AD) is one of the causes of high blood pressure in SCI patients. Recently, spinal cord stimulation (SCS) has been considered as a potential intervention to alleviate unstable blood pressure after SCI. This case series demonstrates the real-time effect of epidural SCS (eSCS) at the lumbosacral spinal cord in mitigating AD in individuals with SCI.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Clinical Neurology
Argyrios Stampas, Michelle Hook, Radha Korupolu, Lavina Jethani, Mahmut T. Kaner, Erinn Pemberton, Sheng Li, Gerard E. Francisco
Summary: This study reviewed the impact of early interventions on spasticity outcomes in individuals with spinal cord injury (SCI). It revealed that spasticity is a common consequence of SCI and can have negative impacts on patients' lives. Early interventions have shown potential in reducing spasticity, but there is limited research in this area. Further studies are needed to explore the potential of early interventions in mitigating spasticity.
THERAPEUTIC ADVANCES IN NEUROLOGICAL DISORDERS
(2022)
Article
Critical Care Medicine
Micaela L. O'Reilly, Eugene Mironets, Tatiana M. Shapiro, Kallon Crowther, Eileen Collyer, John R. Bethea, Veronica J. Tom
Summary: After a severe spinal cord injury, heightened spinal sympathetic reflex activity can lead to autonomic dysreflexia, a life-threatening condition characterized by sudden hypertension. Targeting central sTNF alpha signaling within 2 weeks post-injury is necessary to decrease sympathetic hyperreflexia according to research findings.
JOURNAL OF NEUROTRAUMA
(2021)
Review
Biology
Marisa A. Jeffries, Veronica J. Tom
Summary: Individuals with spinal cord injuries (SCI) exhibit increased susceptibility to infection due to immune dysfunction, which is characterized by immunosuppression and chronic inflammation. Recent research has identified altered sympathetic input to lymphoid organs post-SCI as a key instigator of immune dysfunction, resulting in secondary effects that exacerbate immune pathology. Promising therapies, such as modulation of neuroimmune activity, have shown potential to improve regulation of peripheral immune function in SCI individuals to enhance resistance to deadly infections.
Article
Neurosciences
Ana Karina Kirby, Sidharth Pancholi, Zada Anderson, Caroline Chesler, Thomas H. Everett, Bradley S. Duerstock
Summary: Autonomic dysreflexia (AD) is a condition that affects around 70% of individuals with spinal cord injury (SCI) and can have serious consequences if not detected and managed promptly. Currently, continuous blood pressure monitoring is used as the gold standard for AD detection, but it can be inconvenient. Therefore, a non-invasive detection device would be valuable for rapid and continuous AD detection.
FRONTIERS IN NEUROSCIENCE
(2023)
Article
Clinical Neurology
Nora Civicos Sanchez, Marian Acera, Ane Murueta-Goyena, Nagore Sagastibeltza, Raquel Martinez, Montserrat Cuadrado, Arrate Orueta, Beatriz Tijero, Tamara Fernandez, Rocio Del Pino, Inigo Gabilondo, Maria Luisa Jauregui Abrisqueta, Juan Carlos Gomez Esteban
Summary: Autonomic dysreflexia (AD) is a life-threatening condition in individuals with cervical or high-thoracic spinal cord injury (SCI). This study found a high incidence of AD in SCI patients, with 63.6% of them being asymptomatic during episodes. AD patients showed a decrease in sympathetic outflow and increased baroreflex sensitivity, leading to a higher occurrence of neurogenic orthostatic hypotension. Non-invasively measured autonomic parameters were proposed as a powerful clinical tool to predict AD in SCI patients.
JOURNAL OF NEUROLOGY
(2021)
Article
Medicine, General & Internal
Ahmad H. Alwashmi
Summary: Autonomic dysreflexia is a life-threatening condition that primarily affects patients with spinal cord injuries, causing symptoms such as hypertension, sweating, bradycardia, and hypothermia. Bladder distension is a common trigger, and lack of awareness among medical staff remains an issue.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2022)
Article
Critical Care Medicine
Rahul Sachdeva, Tamila Kalimullina, Kiran Pawar, Andrei Krassioukov
Summary: Spinal cord injury can lead to severe cardiovascular dysfunction and autonomic dysreflexia during bowel routine. The use of lidocaine jelly in bowel care is an effective method to reduce sensory input and significantly decrease the severity of autonomic dysreflexia.
JOURNAL OF NEUROTRAUMA
(2022)
Article
Physiology
Inderjeet S. Sahota, Vera-Ellen M. Lucci, Maureen S. McGrath, H. J. C. (Rianne) Ravensbergen, Victoria E. Claydon
Summary: This study assessed the cardiovascular and cerebrovascular responses of individuals with chronic spinal cord injury (SCI) undergoing urodynamic testing (UDS) and their association with autonomic injury. The results showed that UDS can lead to severe autonomic dysfunction and increased risk of arrhythmia, highlighting the need for continued monitoring during UDS.
FRONTIERS IN PHYSIOLOGY
(2022)
Article
Neurosciences
Kristin Girshin, Rahul Sachdeva, Richard Cohn, Parag Gad, Andrei V. V. Krassioukov, V. Reggie Edgerton
Summary: This study aims to improve sensorimotor function in children with cerebral palsy through a trial combining noninvasive spinal cord neuromodulation and neurorehabilitation therapy. The trial will last for 16 weeks with 60 participants, and the results will be reported on clinicaltrials.gov.
FRONTIERS IN NEUROSCIENCE
(2023)
Review
Neurosciences
James W. Grau, Rachel E. Baine, Paris A. Bean, Jacob A. Davis, Gizelle N. Fauss, Melissa K. Henwood, Kelsey E. Hudson, David T. Johnston, Megan M. Tarbet, Misty M. Strain
EXPERIMENTAL NEUROLOGY
(2020)
Article
Critical Care Medicine
Misty M. Strain, David T. Johnston, Rachel E. Baine, Joshua A. Reynolds, Yung-Jen Huang, Melissa K. Henwood, Gizelle N. Fauss, Jacob A. Davis, Rajesh C. Miranda, Christopher R. West, James W. Grau
Summary: Nociceptive input after spinal cord injury can lead to negative outcomes, including impaired locomotor recovery and increased hemorrhage. Controlling the termination of noxious stimulation or using an inverse agonist can mitigate these adverse effects.
JOURNAL OF NEUROTRAUMA
(2021)
Article
Neurosciences
Gizelle N. K. Fauss, Misty M. Strain, Yung-Jen Huang, Joshua A. Reynolds, Jacob A. Davis, Melissa K. Henwood, Christopher R. West, James W. Grau
Summary: The study suggests that pain input after spinal cord injury may engage rostral processes that exacerbate hemorrhage and drive sustained cardiovascular output. However, an increase in blood pressure is not necessary or sufficient to induce hemorrhage, implicating other brain-dependent processes.
FRONTIERS IN SYSTEMS NEUROSCIENCE
(2021)