International standards to document remaining autonomic function after spinal cord injury

Area of Science:

• Neurology
• Rehabilitation Medicine
• Autonomic Neuroscience

Background:

• Current International Standards for the Neurological Classification of Spinal Cord Injury (SCI) do not assess autonomic function.
• Autonomic dysfunction significantly impacts quality of life and recovery following SCI.
• A standardized method is needed to document autonomic function in SCI patients.

Purpose of the Study:

• To establish a consensus-driven strategy for documenting autonomic neurologic function in individuals with SCI.
• To create a framework for assessing the impact of SCI on various autonomic systems.

Main Methods:

• Convened international experts from the American Spinal Injury Association (ASIA) and International Spinal Cord Society (ISCoS).
• Utilized a combination of online communication, face-to-face meetings, and webcasts for consensus development.
• Developed classifications for bladder, bowel, sexual, cardiovascular, respiratory, sudomotor, and thermoregulatory functions.

Main Results:

• A comprehensive system for documenting autonomic function post-SCI was developed.
• The system covers key areas including cardiovascular, respiratory, sudomotor, thermoregulatory, bladder, bowel, and sexual functions.
• The framework integrates current knowledge of autonomic neuroanatomy.

Conclusions:

• The new system provides a standardized method to document the effects of SCI on autonomic function.
• This framework facilitates consistent communication regarding autonomic deficits following SCI.
• It aims to improve the understanding and management of autonomic complications in SCI survivors.