Mapping the Iceberg of Autonomic Recovery: Mechanistic Underpinnings of Neuromodulation Following Spinal Cord Injury

Overview

Journal Neuroscientist

Publisher Sage Publications

Specialty Neurology

Date 2023 Jan 11

PMID 36631741

Authors

Soshi Samejima

Claire Shackleton

Tiev Miller

Chet T Moritz

Thomas M Kessler

Klaus Krogh

Rahul Sachdeva

Andrei V Krassioukov

Affiliations

Soon will be listed here.

Abstract

Spinal cord injury leads to disruption in autonomic control resulting in cardiovascular, bowel, and lower urinary tract dysfunctions, all of which significantly reduce health-related quality of life. Although spinal cord stimulation shows promise for promoting autonomic recovery, the underlying mechanisms are unclear. Based on current preclinical and clinical evidence, this narrative review provides the most plausible mechanisms underlying the effects of spinal cord stimulation for autonomic recovery, including activation of the somatoautonomic reflex and induction of neuroplastic changes in the spinal cord. Areas where evidence is limited are highlighted in an effort to guide the scientific community to further explore these mechanisms and advance the clinical translation of spinal cord stimulation for autonomic recovery.

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Autonomic dysreflexia in urological practice: pathophysiology, prevention and treatment considerations.

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