Cerebrovascular and blood pressure control at rest and during exercise in Spinal Cord Injury

  • D.A. Low
    Affiliations
    Autonomic and Neurovascular Medicine Unit, Imperial College London, UK

    Autonomic Unit, National Hospital for Neurology and Neurosurgery, UCLH, UK

    Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, UK
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  • C.J. Mathias
    Affiliations
    Autonomic and Neurovascular Medicine Unit, Imperial College London, UK

    Autonomic Unit, National Hospital for Neurology and Neurosurgery, UCLH, UK
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      Spinal Cord Injury (SCI) results in significant cardiovascular autonomic dysfunction dependent on the level and completeness of lesion. Impaired cardiovascular control in SCI is associated with loss of sympathetic neural control of the heart and vasculature and can result in precipitous variations in blood pressure, such as Orthostatic Hypotension and Autonomic Dysreflexia. Individuals with SCI are at higher risk of cerebrovascular disease, such as stroke and transient ischemic attacks. Cerebral blood flow (CBF) is thought to remain relatively constant within a range of blood pressures, known as cerebral autoregulation (CA) which comprises two components; static and dynamic CA. Cerebral blood flow is also modulated by adjustments in systemic hemodynamics (i.e., perfusion pressure and sympathetic nerve activity) and arterial carbon dioxide content (pCO2; cerebrovascular CO2 reactivity). Limited research on CBF control in SCI indicates that static CA is maintained but subtle improvements in dynamic CA may occur. Similarly, reports of altered cerebrovascular CO2 reactivity in SCI are equivocal but subtle improvements may occur.
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