Epidural spinal cord stimulation reduced blood pressure elevation and prevented digital anorectal stimulation-induced autonomic dysreflexia in three individuals with spinal cord injury.
Case Report (n=3)
Does epidural spinal cord stimulation prevent autonomic dysreflexia during digital anorectal stimulation in individuals with spinal cord injury?
Epidural spinal cord stimulation at the lumbosacral spinal cord can prevent autonomic dysreflexia and reduce blood pressure elevation during routine bowel procedures in individuals with severe spinal cord injury.
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.
Samejima et al. (Sun,) conducted a case report in Spinal cord injury with autonomic dysreflexia (n=3). Epidural spinal cord stimulation (eSCS) vs. Without eSCS was evaluated on Elevation in blood pressure and prevention of DARS-induced autonomic dysreflexia. Epidural spinal cord stimulation reduced blood pressure elevation and prevented digital anorectal stimulation-induced autonomic dysreflexia in three individuals with spinal cord injury.