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Disordered cardiovascular control after spinal cord injury

Lynne C Weaver1, Jennifer C Fleming, Christopher J Mathias

  • 1University of Western Ontario, London, Ontario, Canada. lcweaver@robarts.ca

Handbook of Clinical Neurology
|October 27, 2012
PubMed

Insights

Spinal cord injury (SCI) disrupts autonomic pathways, leading to dangerous cardiovascular dysfunction like autonomic dysreflexia and orthostatic hypotension. This significantly impacts quality of life and increases risks for heart disease and stroke in individuals with SCI.

Area of Science:

  • Neuroscience
  • Cardiovascular Physiology
  • Autonomic Nervous System

Background:

  • Spinal cord injury (SCI) severely disrupts autonomic pathways, compromising cardiovascular homeostasis.
  • Cardiovascular dysfunction, including disordered blood pressure control, is prevalent and worsens with injury severity.
  • This dysfunction is a leading cause of death post-SCI, increasing risks for heart disease and stroke.

Purpose of the Study:

  • To review human and animal studies on the pathophysiology and mechanisms of cardiovascular dysfunction after SCI.
  • To elaborate on cardiovascular changes during sexual function and exercise in individuals with SCI.
  • To highlight the need for greater clinical and research focus on these autonomic issues.

Main Methods:

  • Review of existing human and animal studies.
  • Analysis of pathophysiology and mechanisms of specific cardiovascular dysfunctions.
  • Elaboration on functional impacts during exercise and sexual activity.

Main Results:

  • SCI leads to neurogenic shock, orthostatic hypotension, autonomic dysreflexia, and cardiac arrhythmias.
  • Disordered temperature regulation often accompanies these autonomic dysfunctions.
  • Cardiovascular dysfunction significantly impairs rehabilitation and quality of life.

Conclusions:

  • Abnormal cardiovascular control following SCI is a critical, yet often neglected, clinical problem.
  • Increased awareness is driving progress toward integrating assessment of cardiovascular dysfunction into neurological evaluations.
  • Addressing these autonomic issues is crucial for improving outcomes and quality of life for individuals with SCI.

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