Impact of Transcutaneous Spinal Stimulation on Blood Pressure and Orthostasis in Spinal Cord Injury

Impact of Transcutaneous Spinal Stimulation on Blood Pressure and Orthostasis in Spinal Cord Injury: Short and Long-Term Effects

The purpose of this study is to learn whether stimulation applied to the spinal cord through the skin (called transcutaneous spinal stimulation) can help control blood pressure in people with a spinal cord injury.

The main questions this study attempts to solve:

1. What are the immediate effects of spinal cord transcutaneous stimulation on BP?
2. Does stimulation produce lasting improvements in BP regulation and subsequently, daily function?

We want to find out if this stimulation can help both right away (during a session) and over time (after several sessions). Specifically, this study will look at whether spinal stimulation can treat orthostatic hypotension, which is a drop in blood pressure that happens when the patient moves from lying down to sitting or standing up. To take part, one must have had a spinal cord injury for more than one year.

Inclusion Criteria:

• Individuals with a SCI ≥ 1 year after injury

• Injury level ≥ T6 (thoracic level)

• AIS grade A-C

• Cardiovascular dysfunction characterized by one or more of the following:

  1. Persistent hypotension (SBP < 90mmHg)
  2. Orthostatic hypotension (OH, a drop of 20/10 mmHg in SBP/DBP within 5 minutes of standing/upright positioning).

Additionally, experiencing orthostatic symptoms in daily life and/or requiring medication to manage OH.

Exclusion Criteria:

• Current illness (e.g., infection, a pressure injury that might interfere with the intervention)
• Ventilator-dependent
• History of implanted brain/spine/nerve stimulators
• Cardiac pacemaker/defibrillator or intra-cardiac lines
• Significant coronary artery or cardiac conduction disease, a recent history of myocardial infarction
• History of seizures
• pregnancy
• Insufficient mental capacity to understand and independently provide consent
• Deemed unsuitable by the study physician