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Cerebrovascular responses to orthostatic stress after spinal cord injury.
MedLine Citation:
PMID:  22720841     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Orthostatic hypotension (OH) is a debilitating condition affecting individuals with spinal cord injury (SCI) that may be associated with cerebral hypoperfusion. We studied orthostatic cerebral control in individuals with SCI with different levels and severities of injury to spinal cardiovascular autonomic pathways. We measured beat-to-beat cardiovascular and cerebrovascular responses to passive orthostatic stress in 16 controls and 26 subjects with chronic SCI. Cerebrovascular control was assessed from diastolic cerebral blood flow velocity (CBFVD), and indices of static and dynamic cerebral autoregulation. Severity of autonomic injury was inferred from spectral analyses of systolic arterial pressure, and supine plasma noradrenaline concentrations. Symptoms of OH were evaluated using questionnaires. CBFVD decreased during orthostasis only in individuals with autonomically complete injuries above T6. Orthostatic CBFVD was significantly correlated (p<0.05) with severity of autonomic injury. Individuals with injuries above T6 had impaired dynamic autoregulation (p<0.05) compared to controls, that was correlated (p<0.05) with severity of autonomic injury. Individuals with autonomically complete SCI reported increased severity of symptoms relative to controls (p<0.05). Symptom severity was correlated with the efficacy of dynamic autoregulation. During orthostatic stress SCI individuals have impaired cerebrovascular control that is related to the level and severity of autonomic injury.
Authors:
Inderjeet S Sahota; Henrike Rianne Jc Ravensbergen; Maureen S McGrath; Victoria E Claydon
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-21
Journal Detail:
Title:  Journal of neurotrauma     Volume:  -     ISSN:  1557-9042     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8811626     Medline TA:  J Neurotrauma     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Simon Fraser University, Biomedical Physiology and Kinesiology, Burnaby, British Columbia, Canada; isahota@sfu.ca.
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