Grant: Project Grant

Spinal cord injury (SCI) leads to dramatic alterations in physical and mental well-being. It is well understood that people with severe SCI lose their ability to move, however, a lesser-known consequence of SCI is the profound disruption of blood pressure (BP) regulation. People with SCI experience rapid fluctuations in their BP that leads to dizziness and nausea up to 40 times per day, greatly affecting their quality of life. These frequent fluctuations in BP contribute to an increased risk for stroke and heart disease, which is the most common cause of death in people with SCI. Current management of BP instability is limited to long-acting drugs that may only be sufficient in mild cases. We have shown that an implantable device can regulate BP in preclinical models of SCI and in two patients with profound BP instability. This device consists of an electrode array that is surgically implanted over the region of the spinal cord that contains the neural circuits that regulate BP and an implantable pulse generator that delivers electrical stimulation to these circuits. The aim of this project is to test the effect of stimulating this specific location of the spinal cord and its effects on BP in people with severe SCI in their necks (cervical spine). This population experiences the worst disruption to their BP regulation and to their quality of life. We will also assess the long-term safety of this device and its effects on the cardiovascular and cardiorespiratory systems. We anticipate that this device will improve BP regulation and quality of life for all of the participants that are implanted when compared to a control population of people living with SCI. Furthermore, the results of this research will inform the methodology for a large-scale clinical trial that will allow us to move this therapy along toward clinical indication.