What question did this study set out to answer?

To investigate regional sympathetic nervous system activity above and below the lesion level during mental stress and bladder-induced autonomic dysreflexia in individuals with high spinal cord injury.

September 1, 1998BrainOpen Access

Regional sympathetic function in high spinal cord injury during mental stress and autonomic dysreflexia

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Why the study?

How does regional sympathetic function respond to mental stress and autonomic dysreflexia in subjects with high spinal cord injury compared to healthy controls?

Population

9 subjects with high spinal cord injury and 10 weight- and age-matched healthy controls.

Comparison

Mental stress and bladder stimulation vs Baseline resting state and healthy control…

Design

Case-control

Authors

AKA. KarlssonUniversity of Gothenburg

Discussion

Member takes

Implication

Exaggerated sympathetic spillover in high SCI may warrant clinical vigilance during stress or bladder stimulation; leaves open links to cardiovascular risk.

Key Points

To investigate regional sympathetic nervous system activity above and below the lesion level during mental stress and bladder-induced autonomic dysreflexia in individuals with high spinal cord injury.
Assessed 9 subjects with cervical or high-thoracic spinal cord injury (C7–T4, mean duration 13.8 years) and 10 age- and weight-matched healthy control subjects at rest and during mental stress.
Measured forearm and leg regional noradrenaline spillover using steady-state isotope dilution at baseline, during mental stress, and following bladder stimulation.
Quantified limb blood flow via occlusion plethysmography and body composition using dual-energy X-ray absorptiometry.
Mental stress provoked larger increases in heart rate (76 vs. 64 beats/min; P < 0.05) and forearm noradrenaline spillover (2.73 vs. 1.71 pmol/min/100 g; P < 0.05) in spinal cord injury subjects compared to controls.
Total body (2,826 vs. 3,783 pmol/min; P < 0.01) and leg noradrenaline spillover (0.23 vs. 0.41 pmol/min/100 g; P < 0.05) increased during mental stress exclusively in healthy controls.
Bladder stimulation in injured subjects triggered a surge in mean arterial pressure, reduced leg blood flow, and raised leg noradrenaline spillover from 0.06 to 0.91 pmol/min/100 g (P < 0.05).

Structured PICO

How does regional sympathetic function respond to mental stress and autonomic dysreflexia in subjects with high spinal cord injury compared to healthy controls?

Population

9 subjects with high spinal cord injury (level C7-T4, mean age 41 years, mean duration of injury 13.8 years) and 10 weight- and age-matched healthy controls.

Intervention

Mental stress and bladder stimulation (autonomic dysreflexia)

Comparator

Baseline resting state and healthy control subjects

Outcome

Regional noradrenaline spillover above (forearm) and below (leg) the level of the lesion measured by steady-state isotope dilution techniquesurrogate

In high spinal cord injury, peripheral afferent stimulation below the lesion causes marked noradrenaline spillover from the decentralized sympathetic nervous system, while centrally mediated stimulation induces an exaggerated response above the lesion.

Cite This Study

A. Karlsson (1998) studied this question.

synapsesocial.com/papers/6a81a2fca2b9faa7beb6c008 https://doi.org/10.1093/brain/121.9.1711

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Implication

Exaggerated sympathetic spillover in high SCI may warrant clinical vigilance during stress or bladder stimulation; leaves open links to cardiovascular risk.

Regional sympathetic function in high spinal cord injury during mental stress and autonomic dysreflexia

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Regional sympathetic function in high spinal cord injury during mental stress and autonomic dysreflexia

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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