Pulse volume recording disturbances in paraplegic patients

Area of Science:

• Vascular Medicine
• Neurology
• Regenerative Medicine

Background:

• Spinal cord injuries (SCI) can significantly alter physiological functions in affected individuals.
• Vascular reactivity in denervated regions following SCI is not well understood.
• Impaired vascular function may contribute to complications such as poor wound healing in paraplegic patients.

Purpose of the Study:

• To investigate vascular reactivity in patients with spinal cord injuries.
• To identify potential alterations in peripheral vascular function in paraplegic individuals.
• To explore the relationship between altered vascular response and clinical outcomes like wound healing.

Main Methods:

• A cohort of 30 paraplegic patients with traumatic spinal cord injuries underwent comprehensive vascular examinations.
• Peripheral pulses and segmental Doppler pressure measurements were assessed.
• Plethysmography, specifically pulse volume recording (PVR), was utilized to evaluate vascular pulsatility.

Main Results:

• All patients exhibited normal peripheral pulses and Doppler pressures.
• While 8 patients had normal PVR waveforms, 22 (73%) demonstrated PVR waveforms indicating poor pulsatility despite normal arterial pressures.
• Patients with altered pulsatility were older and had a longer duration since injury compared to those with normal PVR.

Conclusions:

• A significant proportion of paraplegic patients exhibit altered peripheral vascular pulsatility, characterized by normal pressures but reduced waveform pulsatility.
• This altered vascular response, particularly evident in older patients with chronic SCI, may be a contributing factor to the frequent occurrence of deficient wound healing below the neurological level of injury.
• Further research is warranted to elucidate the mechanisms and clinical implications of these vascular changes in SCI patients.