Key result
Extreme blood pressure lability following spinal cord injury, characterized by orthostatic hypotension and autonomic dysreflexia, may contribute to vascular cognitive impairment.
Why the study?
Cardiovascular dysfunction and extreme blood pressure fluctuations significantly contribute to cognitive decline following spinal cord injury, but the mechanisms linking blood pressure lability to vascular cognitive impairment in this population require review.
Extreme blood pressure fluctuations following spinal cord injury may significantly contribute to vascular cognitive impairment, highlighting a need for targeted blood pressure management therapies in this population.
Cardiovascular dysfunction may contribute to cognitive impairment in SCI; leaves open targeted interventions pending prospective trials.
Cognitive impairment following spinal cord injury (SCI) has received considerable attention in recent years. Among the various systemic effects of SCI that contribute towards cognitive decline in this population, cardiovascular dysfunction is arguably one of the most significant. The majority of individuals with a cervical or upper-thoracic SCI commonly experience conditions called orthostatic hypotension and autonomic dysreflexia, which are characterized by dangerous fluctuations in systemic blood pressure (BP). Herein, we review the potential impact of extreme BP lability on vascular cognitive impairment (VCI) in individuals with SCI. Albeit preliminary in the SCI population, there is convincing evidence that chronic hypotension and hypertension in able-bodied individuals results in devastating impairments in cerebrovascular health, leading to VCI. We discuss the pertinent literature, and while drawing mechanistic comparisons between able-bodied cohorts and individuals with SCI, we emphasize the need for additional research to elucidate the mechanisms of cognitive impairment specific to the SCI population. Lastly, we highlight the current and potential future therapies to manage and treat BP instability, thereby possibly mitigating VCI in the SCI population.
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Sachdeva et al. (2019) conducted a review in Spinal cord injury. Extreme blood pressure lability was evaluated on Vascular cognitive impairment. Extreme blood pressure lability following spinal cord injury, characterized by orthostatic hypotension and autonomic dysreflexia, may contribute to vascular cognitive impairment.
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