Alleviating Hypotension With Implanted Peripheral Nerve Stimulation for Seated Stabilization: A Case Report in SCI

A spinal cord injury can compromise trunk stability and autonomic functions leading to poor blood pressure regulation and hindering daily activities. Implanted multichannel motor system neuroprostheses can stabilize the trunk by electrically activating the peripheral nerves to contract the paralyzed lumbar spine and hip extensor muscles. This case report presents novel observations of improved blood pressure regulation for a 59-yr-old female patient with a spinal cord injury C5 American Spinal Injury Association Impairment Scale (AIS-A) while utilizing an implanted neuroprosthesis. The participant experienced immediate relief from common symptoms of hypotension (lightheadedness, blurred vision, and occasional syncope) when using the implanted neuroprosthesis to contract paraspinal, gluteal, and hamstrings muscles to complete activities of daily living. During laboratory assessments, stable increases in blood pressure were recorded when using the neuroprosthesis for seated trunk stabilization. These observations demonstrate that neuroprostheses targeting the peripheral nerves of the lumbar spine and pelvic musculature have the potential to aid in blood pressure regulation and relieve hypotensive symptoms during orthostasis. These findings provide support for the use of an implanted neuroprosthesis on acute blood pressure regulation and the potential to address important systemic health-related issues following spinal cord injury.