Epidural Spinal Cord Stimulation Training and Sustained Recovery of Cardiovascular Function in Individuals With Chronic Cervical Spinal Cord Injury

Abstract

This cohort study evaluates the feasibility of daily customized epidural stimulation configurations targeted for cardiovascular function in individuals with chronic, cervical motor-complete spinal cord injury.

Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Figures

Figure.. Cardiovascular Response to Orthostatic Stress With Stimulation and After Cardiovascular Stimulation Intervention

A, Exemplary data from participant A41 before the intervention without stimulation demonstrates a significant decrease (P < .001) in mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) and increase (P < .001) in heart rate (HR) during a sit-up test. B, Before the intervention with stimulation, there was no significant decrease (P = .72) in mean SBP and DBP, while HR increased significantly (P < .001) during a sit-up test. Amplitude of stimulation is represented in volts; configuration of the numbered electrode array is illustrated at right: black is anode, gray is cathode, and white is inactive. C, After the intervention without stimulation, there was no significant decrease (P = .42) in SBP and DBP, while HR increased significantly (P = .002) during the sit-up test. D, Data from all 4 participants are averaged for these conditions; stimulation is depicted by diagonal bars. In all participants, before intervention without stimulation, mean SBP decreased significantly from supine to a sitting position (P = .001). The decrease in mean DBP from supine to a sitting position was not significant (P = .64). Mean HR increased significantly (P < .001) from supine to a sitting position. Before intervention with stimulation, there was no significant difference in SBP and DBP from supine to a sitting position (SBP, P = .15; DBP, P = .16); HR increased significantly (P < .001). After intervention without stimulation, SBP and DBP was not significantly different from supine to a sitting position (SBP, P = .36; DBP, P = .87); HR while sitting increased significantly from supine to a sitting position (P < .001). Error bars indicate SD.