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Samejima S, Shackleton C, Malik RN, Cao K, Bohorquez A, Nightingale TE, Sachdeva R, Krassioukov AV. Spinal Cord Stimulation Prevents Autonomic Dysreflexia in Individuals with Spinal Cord Injury: A Case Series. J Clin Med 2023; 12:jcm12082897. [PMID: 37109234 PMCID: PMC10146034 DOI: 10.3390/jcm12082897] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Spinal cord injury (SCI) results in severe cardiovascular dysfunction due to the disruption of supraspinal control. Autonomic dysreflexia (AD), an uncontrolled rise in blood pressure in response to peripheral stimuli including common bowel routine, digital anorectal stimulation (DARS), reduces the quality of life, and increases morbidity and mortality. Recently, spinal cord stimulation (SCS) has emerged as a potential intervention to mitigate unstable blood pressure following SCI. The objective of this case series was to test the real-time effect of epidural SCS (eSCS) at the lumbosacral spinal cord, the most common implant location, on mitigating AD in individuals with SCI. We recruited three individuals with cervical and upper thoracic motor-complete SCI who have an implanted epidural stimulator. We demonstrated that eSCS can reduce the elevation in blood pressure and prevent DARS-induced AD. The blood pressure variability analysis indicated that eSCS potentially reduced vascular sympathetic nervous system activity during DARS, compared to without eSCS. This case series provides evidence to support the use of eSCS to prevent AD episodes during routine bowel procedures, improving the quality of life for individuals with SCI and potentially reducing cardiovascular risks.
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Affiliation(s)
- Soshi Samejima
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC V5Z 2G9, Canada
| | - Claire Shackleton
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC V5Z 2G9, Canada
| | - Raza N Malik
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC V5Z 2G9, Canada
| | - Kawami Cao
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC V5Z 2G9, Canada
| | - Anibal Bohorquez
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC V5Z 2G9, Canada
- Spinal Cord Program, GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC V5Z 2G9, Canada
| | - Tom E Nightingale
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
- Centre for Trauma Sciences Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Rahul Sachdeva
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC V5Z 2G9, Canada
| | - Andrei V Krassioukov
- International Collaboration on Repair Discoveries, Faculty of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, BC V5Z 2G9, Canada
- Spinal Cord Program, GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC V5Z 2G9, Canada
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Reebye R, Finlayson H, May C, Satkunam L, Wein T, Miller T, Boulias C, O’Connell C, Bohorquez A, Dukelow S, Ethans K, Ismail F, Khalil W, Khan O, Lagnau P, McNeil S, Mills P, Sirois G, Winston P. Practical Guidance for Outpatient Spasticity Management During the Coronavirus (COVID-19) Pandemic: Canadian Spasticity COVID-19 Task Force. Can J Neurol Sci 2020; 47:589-593. [PMID: 32450934 PMCID: PMC7298095 DOI: 10.1017/cjn.2020.104] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 11/21/2022]
Affiliation(s)
- Rajiv Reebye
- GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
- Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
| | - Heather Finlayson
- GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
- Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
| | - Curtis May
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lalith Satkunam
- Glenrose Rehabilitation Hospital and Division of Physical Medicine & Rehabilitation, University of Alberta, Edmonton, Alberta, Canada
| | - Theodore Wein
- Stroke Prevention Clinic, Montreal General Hospital and McGill University Health Center, Montreal, Québec, Canada
| | - Thomas Miller
- St. Joseph’s Health Care London, Western University, London, Ontario, Canada
| | - Chris Boulias
- West Park Healthcare Centre, Toronto, Ontario, Canada
- Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
| | - Colleen O’Connell
- Stan Cassidy Centre, Fredericton, New Brunswick, Canada
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anibal Bohorquez
- GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
- Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sean Dukelow
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Karen Ethans
- Department of Internal Medicine’s Section of Physical Medicine and Rehabilitation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Farooq Ismail
- West Park Healthcare Centre, Toronto, Ontario, Canada
- Physical Medicine and Rehabilitation, University of Toronto, Toronto, Ontario, Canada
| | - Waill Khalil
- Department of Physical Medicine and Rehabilitation, Saskatoon City Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Omar Khan
- Regional Rehabilitation Centre, Hamilton, Ontario, Canada
| | - Philippe Lagnau
- GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
| | - Stephen McNeil
- Hotel Dieu Shaver Health and Rehabilitation Centre, St. Catharines, Ontario, Canada
- Foothills Medical Centre, Calgary and Department of Clinical Neurosciences, Alberta, Canada
| | - Patricia Mills
- GF Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
| | - Geneviève Sirois
- University of Calgary, Calgary, Alberta, Canada
- Institute of Rehabilitation and Physical Impairment of Quebec City and Laval University, Québec City, Québec, Canada
| | - Paul Winston
- Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
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