ReviewAutonomic neuroscience : basic & clinical2022
Toward rebalancing blood pressure instability after spinal cord injury with spinal cord electrical stimulation: A mini review and critique of the evolving literature.
Review in Autonomic neuroscience : basic & clinical, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Strategies to Augment the Cardiovascular System and Acutely Enhance Exercise Performance in Individuals with Spinal Cord Injury: A Systematic Scoping Review.Sports medicine - open · 2025Pooled it
- Evaluation and management of autonomic functions in patients with spinal cord injury: A scoping review.The journal of spinal cord medicine · 2026Article
- Approach to Cardiovascular Autonomic Dysfunction in Patients with Synucleinopathies.Movement disorders clinical practice · 2025Review
- Sustained therapeutic effect of spinal cord stimulation on improving severe neurogenic orthostatic hypotension in a patient with pure autonomic failure converting to multiple system atrophy.Journal of neurology · 2025Article
- Autonomic dysfunction and hemodynamic management after acute spinal cord injury: blood pressure targets, perfusion strategies, and emerging therapies.Frontiers in neurology · 2025Review
- Prevalence of autonomic dysreflexia during spinal cord stimulation after spinal cord injury.Journal of neurophysiology · 2024Article
- Improving neurological deficits secondary to transverse myelitis using epidural spinal cord stimulation: illustrative cases.Journal of neurosurgery. Case lessons · 2024Article
- Epidural Spinal Cord Stimulation for Spinal Cord Injury in Humans: A Systematic Review.Journal of clinical medicine · 2024Review
- Transcutaneous spinal cord stimulation and its impact on cardiovascular autonomic regulation after spinal cord injury.American journal of physiology. Heart and circulatory physiology · 2024Article
- Pain-induced autonomic dysreflexia secondary to spinal cord injury with significant improvement after spinal cord stimulator implantation.Interventional pain medicine · 2023Article
- Commentary: Spinal Cord Stimulation to Improve Autonomic Regulation After Spinal Cord Injury: Can Reflex Control Be Restored.Topics in spinal cord injury rehabilitation · 2023Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
High-level spinal cord injury commonly leads to blood pressure instability. This manifests clinically as orthostatic hypotension (OH), where blood pressure can drop to the point of loss of consciousness, and autonomic dysreflexia (AD), where systolic blood pressure can climb to over 300 mmHg in response to an unperceived noxious stimulus. These blood pressure fluctuations can occur multiple times a day, contributing to increased vessel shear stress and heightened risk of cardiovascular disease. The pathophysiology of both of these conditions is rooted in impairments in regulation of spinal cord sympathetic preganglionic neurons, which control blood pressure by mediating vascular resistance and catecholamine release. Recently, spinal cord electrical stimulation has provided evidence that it may modulate these blood pressure imbalances. Early proposed mechanisms suggest activation of spinal cord dorsal horn neurons that ultimately act upon the sympathetic preganglionic neuronal pathways. For OH, spinal cord stimulation likely induces local activation of these neurons to generate baseline sympathetic tone and accompanying vasoconstriction. The mechanisms for spinal stimulation regulating AD are less clear, though some suggest it activates inhibitory circuits to dampen the overactive sympathetic response. While questions remain, spinal cord electrical stimulation is an intriguing new modality that may restore blood pressure regulation following spinal cord injury.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.