Mapping the Iceberg of Autonomic Recovery: Mechanistic Underpinnings of Neuromodulation following Spinal Cord Injury

Soshi Samejima; Claire Shackleton; Tiev Miller; Chet T. Moritz; Thomas M. Kessler; Klaus Krogh; Rahul Sachdeva; Andrei V. Krassioukov

doi:10.1177/10738584221145570

Mapping the Iceberg of Autonomic Recovery: Mechanistic Underpinnings of Neuromodulation following Spinal Cord Injury

Soshi Samejima, Claire Shackleton, Tiev Miller, Chet T. Moritz, Thomas M. Kessler, Klaus Krogh, Rahul Sachdeva, Andrei V. Krassioukov

Rehabilitation Medicine

Research output: Contribution to journal › Review article › peer-review

13 Scopus citations

Abstract

Spinal cord injury leads to disruption in autonomic control resulting in cardiovascular, bowel, and lower urinary tract dysfunctions, all of which significantly reduce health-related quality of life. Although spinal cord stimulation shows promise for promoting autonomic recovery, the underlying mechanisms are unclear. Based on current preclinical and clinical evidence, this narrative review provides the most plausible mechanisms underlying the effects of spinal cord stimulation for autonomic recovery, including activation of the somatoautonomic reflex and induction of neuroplastic changes in the spinal cord. Areas where evidence is limited are highlighted in an effort to guide the scientific community to further explore these mechanisms and advance the clinical translation of spinal cord stimulation for autonomic recovery.

Original language	English
Pages (from-to)	378-389
Number of pages	12
Journal	Neuroscientist
Volume	30
Issue number	3
DOIs	https://doi.org/10.1177/10738584221145570
State	Published - Jun 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2023.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: A.V.K. held the endowed chair in rehabilitation medicine, University of British Columbia, and his laboratory was supported by funds from the Canadian Institute for Health Research, Canadian Foundation for Innovation and BC Knowledge Development Fund, International Spinal Research Trust, Rick Hansen Foundation, PRAXIS Spinal Cord Institute, Wings for Life Research Foundation, and US Department of Defense. S.S. was supported by a Paralyzed Veterans of America Fellowship and by the Wings for Life Spinal Cord Research Foundation. C.S. was supported by a Paralyzed Veterans of America Fellowship. T.M. was supported by a Michael Smith Health Research BC Fellowship. R.S. was supported by the Wings for Life Spinal Cord Research Foundation and the US Department of Defense.

Funders	Funder number
Rick Hansen Foundation
Michael Smith Foundation for Health Research
Univ. of Northern British Columbia
Wings for Life Spinal Cord Research Foundation
Wings for Life Spinal Cord Research Foundation
Canadian Institutes of Health Research
U.S. Department of Defense

Keywords

autonomic function
bowel function
cardiovascular function
lower urinary tract function
spinal cord injury
spinal cord stimulation

ASJC Scopus subject areas

General Neuroscience
Clinical Neurology

Access to Document

10.1177/10738584221145570

Cite this

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abstract = "Spinal cord injury leads to disruption in autonomic control resulting in cardiovascular, bowel, and lower urinary tract dysfunctions, all of which significantly reduce health-related quality of life. Although spinal cord stimulation shows promise for promoting autonomic recovery, the underlying mechanisms are unclear. Based on current preclinical and clinical evidence, this narrative review provides the most plausible mechanisms underlying the effects of spinal cord stimulation for autonomic recovery, including activation of the somatoautonomic reflex and induction of neuroplastic changes in the spinal cord. Areas where evidence is limited are highlighted in an effort to guide the scientific community to further explore these mechanisms and advance the clinical translation of spinal cord stimulation for autonomic recovery.",

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AU - Moritz, Chet T.

AU - Kessler, Thomas M.

AU - Krogh, Klaus

AU - Sachdeva, Rahul

AU - Krassioukov, Andrei V.

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AB - Spinal cord injury leads to disruption in autonomic control resulting in cardiovascular, bowel, and lower urinary tract dysfunctions, all of which significantly reduce health-related quality of life. Although spinal cord stimulation shows promise for promoting autonomic recovery, the underlying mechanisms are unclear. Based on current preclinical and clinical evidence, this narrative review provides the most plausible mechanisms underlying the effects of spinal cord stimulation for autonomic recovery, including activation of the somatoautonomic reflex and induction of neuroplastic changes in the spinal cord. Areas where evidence is limited are highlighted in an effort to guide the scientific community to further explore these mechanisms and advance the clinical translation of spinal cord stimulation for autonomic recovery.

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Mapping the Iceberg of Autonomic Recovery: Mechanistic Underpinnings of Neuromodulation following Spinal Cord Injury

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

Access to Document

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