Enhanced cardiovascular function with spinal cord transcutaneous stimulation in high-level spinal cord injury

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Kessler Foundation researchers published new findings on neuromodulation in individuals with high-level spinal cord injury (SCI) using spinal cord transcutaneous stimulation (scTS). This promising approach to enhance cardiovascular regulation addresses the challenges of unstable blood pressure and the accompanying hypotensive and hypertensive events following SCI.

The findings revealed that in individuals with low blood pressure following a SCI, scTS at the lumbosacral vertebrae region was able to significantly elevate blood pressure, unlike cervical or upper thoracic stimulation. This trend, consistent across eight participants in the case series, highlights the potential for scTS to be used as a non-invasive therapeutic intervention to regulate cardiovascular function in SCI patients.

The article, “Neuromodulation in Spinal Cord Injury Using Transcutaneous Spinal Stimulation — Mapping for a Blood Pressure Response: A Case Series,” was published open access on September 20, 2024, in Neurotrauma Reports.

Kessler Foundation authors included Einat Engel-Haber, MD, Akhil Bheemreddy, Mehmed B. Bayram, PhD, Manikandan Ravi, Fan Zhang, PhD, Steven Kirshblum, MD, and Gail F. Forrest, PhD, in addition to Haiyan Su, PhD, School of Computing, Montclair State University.

While scTS may offer flexibility in stimulation locations, as opposed to epidural stimulation — another common method of spinal cord stimulation — it also leads to significant variability and lack of validation in stimulation sites used by studies. “In individuals with high thoracic or cervical SCI, blood pressure instability can limit daily activities and lead to short- and long-term health complications. Choosing the most suitable stimulation sites plays a key role in enhancing cardiovascular control in these patients,” explained lead author Dr. Einat Engel-Haber, associate research scientist in the Tim and Caroline Reynolds Center for Spinal Stimulation, the Foundation Center that supported the study.

“The research highlights the potential for developing new therapeutic options to address cardiovascular instability in individuals with SCI, a common challenge for this population,” she added. “These findings open up avenues for further studies on how scTS can improve quality of life for those living with spinal cord injury and offer valuable insights for clinicians and researchers aiming to develop personalized stimulation protocols that target cardiovascular function in individuals with SCI,” concluded Dr. Engel-Haber.

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