Spinal cord stimulation and cerebral haemodynamics

Area of Science:

• Neuroscience
• Cerebrovascular Physiology

Background:

• Previous studies indicated spinal cord stimulation (SCS) increases regional cerebral blood flow (rCBF).
• The precise mechanisms and consistency of SCS effects on cerebral blood flow require further investigation.

Purpose of the Study:

• To verify the effect of SCS on CBF using two distinct measurement techniques.
• To compare the efficacy and consistency of the 133-Xenon wash-out technique and transcranial Doppler sonography (TCD) in assessing SCS-induced CBF changes.
• To evaluate the correlation between the spinal cord stimulation level and alterations in CBF.

Main Methods:

• Regional cerebral blood flow (rCBF) was measured in 8 patients using the 133-Xenon wash-out technique.
• rCBF was assessed in 28 patients using transcranial Doppler sonography (TCD).
• In two patients, both methods were employed, and the effect of SCS on CO2 autoregulation was studied via TCD.

Main Results:

• Spinal cord stimulation (SCS) was confirmed to interact with cerebral blood flow (CBF) regulation mechanisms.
• Stimulation at different spinal cord levels produced reproducible and variable effects on CBF.
• Cervical spinal cord stimulation was more frequently associated with an increase in CBF.
• Both 133-Xe and TCD methods showed consistent directional changes in CBF due to SCS.
• Preliminary findings suggest a competitive interaction between CO2 and SCS in regulating CBF.

Conclusions:

• SCS demonstrably influences cerebral blood flow regulation.
• Cervical spinal cord stimulation is particularly effective in increasing CBF.
• The 133-Xenon and TCD methods provide comparable assessments of SCS-induced CBF modifications.
• Further research is warranted to elucidate the interplay between CO2 and SCS in CBF control.