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Journal article
Autonomic dysreflexia: a cardiovascular disorder following spinal cord injury
Neural regeneration research, v 12(9), pp 1390-1400
01 Sep 2017
PMID: 29089975
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Autonomic dysreflexia (AD) is a serious cardiovascular disorder in patients with spinal cord injury (SCI). The primary underlying cause of AD is loss of supraspinal control over sympathetic preganglionic neurons (SPNs) caudal to the injury, which renders the SPNs hyper-responsive to stimulation. Central maladaptive plasticity, including C-fiber sprouting and propriospinal fiber proliferation exaggerates noxious afferent transmission to the SPNs, causing them to release massive sympathetic discharges that result in severe hypertensive episodes. In parallel, upregulated peripheral vascular sensitivity following SCI exacerbates the hypertensive response by augmenting gastric and pelvic vasoconstriction. Currently, the majority of clinically employed treatments for AD involve anti-hypertensive medications and Botox injections to the bladder. Although these approaches mitigate the severity of AD, they only yield transient effects and target the effector organs, rather than addressing the primary issue of central sympathetic dysregulation. As such, strategies that aim to restore supraspinal reinnervation of SPNs to improve cardiovascular sympathetic regulation are likely more effective for AD. Recent pre-clinical investigations show that cell transplantation therapy is efficacious in reestablishing spinal sympathetic connections and improving hemodynamic performance, which holds promise as a potential therapeutic approach.
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Details
- Title
- Autonomic dysreflexia: a cardiovascular disorder following spinal cord injury
- Creators
- Hisham Sharif - Drexel UniversityShaoping Hou - Drexel University
- Publication Details
- Neural regeneration research, v 12(9), pp 1390-1400
- Publisher
- Wolters Kluwer Medknow Publications
- Number of pages
- 11
- Grant note
- R01NS099076 / NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS) R01NS099076 / NIH NINDS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS) Morton Cure Paralysis Funds (MCPF)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurobiology and Anatomy
- Web of Science ID
- WOS:000412978200002
- Scopus ID
- 2-s2.0-85032439743
- Other Identifier
- 991019167726404721
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Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Cell Biology
- Neurosciences