Spinal cord stimulation and cerebral haemodynamics

Area of Science:

• Neurology
• Neurosurgery
• Medical Devices

Background:

• Spinal cord stimulation (SCS) was previously shown to improve peripheral blood flow.
• Early studies by Hosobuchi in 1986 investigated the effects of SCS on human cerebral blood flow (CBF).

Purpose of the Study:

• To investigate the effects of SCS on cerebral blood flow (CBF) in humans.
• To explore the therapeutic potential of SCS for various neurological conditions, including cerebral ischemia and stroke.

Main Methods:

• Utilized SPECT and Transcranial Doppler (TCD) techniques to measure CBF variations.
• Conducted experimental studies in animal models (cats and rats) and clinical observations in human patients.

Main Results:

• SCS can either increase, decrease, or have no effect on CBF, with cervical stimulation frequently increasing CBF (61%).
• SCS demonstrated a competitive interaction with CO2 in regulating CBF, leading to reversible functional sympathectomy.
• Experimental data showed SCS prevented cerebral infarction progression in cats, improved symptoms in vegetative states, reduced headaches, and decreased ischemic brain edema in rats.

Conclusions:

• Cervical SCS was first used therapeutically for cerebral ischemia in humans in 1991.
• Recent findings confirm the therapeutic efficacy of SCS in treating ischemic stroke, experimental brain injury, and cerebral vasospasm.