Grant: Project Grant

Spinal cord injury (SCI) is a devastating medical condition that forever changes the trajectory of life. It is also extremely costly, similar to that of traumatic brain injury or Alzheimer's disease. People with SCI report unconscious bodily functions such as those of the cardiovascular system as top health priorities. One primary cardiovascular dysfunction after SCI is termed "autonomic dysreflexia", which describes rapid and severe episodic hypertension in response to sensory input to the spinal cord below the level of injury. These episodes occur multiple times per day after SCI. Single episodes of autonomic dysreflexia can result in heart disease and stroke. Long-term exposure to autonomic dysreflexia impairs the structure and function of the cardiovascular system and is associated with increased rates of heart disease. This is important as heart disease is three times more common in people with SCI, and there are no effective therapies for autonomic dysreflexia after SCI. We developed a device that electrically stimulates the circuits underlying blood pressure stability after SCI (Nature, 2021), and have exciting preliminary data showing that long-term use of this device completely prevents autonomic dysreflexia. Our study aims to answer several questions that are important to people with SCI and the doctors that treat them. First, can this treatment be started early or late after SCI and still prevent autonomic dysreflexia, and does autonomic dysreflexia develop again once the therapy is stopped? Second, does the treatment improve the health of the cardiovascular system? Third, does the therapy work by fixing the known unhealthy changes in the nervous system that occur after SCI that are responsible for autonomic dysreflexia? Over the long-term, the knowledge from this project may highlight an effective new therapy for treating autonomic dysreflexia after SCI.