Grant: CIHR Fellowship

In able-bodied people, brain signals maintain blood pressure by controlling blood vessels. In people with spinal cord injury, these signals are disrupted, leading to sharp drops in blood pressure when sitting up or after eating. This causes dizziness, brain fog, and fainting, severely reducing quality of life. Blood pressure issues increase the risk of cardiovascular disease, the leading cause of death after spinal cord injury. Addressing this issue is rated as a top priority by people with spinal cord injury, even above walking again. Spinal cord stimulation is a promising therapy that uses an implantable device to electrically stimulate the cord. Stimulation of the lower spinal cord has been used to attempt to restore walking. Notably, this treatment has long-lasting effects even in the absence of stimulation, which gave us the idea that it may be used to affect blood pressure in a permanent way as well. Preliminary data from our lab show that stimulation of the middle spinal cord raises blood pressure, preventing fainting when sitting up. Although stimulating this region does not restore walking, improved blood pressure control improves quality of life, enables people to return to work and socializing, and may reduce risk of death. However, no full-scale studies have explored the long-term impact of spinal cord stimulation on the cardiovascular system or if it can reverse blood pressure issues without ongoing stimulation. I will study how long-term stimulation affects blood pressure control in people with spinal cord injury. First, I will test if long-term spinal cord stimulation restores blood pressure control during upright posture, both with stimulation on and off. I will also test if chronic spinal cord stimulation repairs spinal cord pathways controlling blood pressure. These findings will guide development of therapies that could reduce cardiovascular disease and improve quality of life, independent of restoring walking, in people with spinal cord injury.