A comparison of static and dynamic cerebral autoregulation during mild whole-body cold stress in individuals with and without cervical spinal cord injury: a pilot study.

Jan W van der Scheer, Yoshi-Ichiro Kamijo, Christof A Leicht, Philip J Millar, Manabu Shibasaki, Victoria L Goosey-Tolfrey, Fumihiro Tajima

Journal: Spinal cord 2018;56(5):469-477

PMID: 29330514

Full Text on Nature Publishing Group View on PubMed

Abstract

STUDY DESIGN

Experimental study.

OBJECTIVES

To characterize static and dynamic cerebral autoregulation (CA) of individuals with cervical spinal cord injury (SCI) compared to able-bodied controls in response to moderate increases in mean arterial pressure (MAP) caused by mild whole-body cold stress.

SETTING

Japan METHODS: Five men with complete autonomic cervical SCI (sustained > 5 y) and six age-matched able-bodied men participated in hemodynamic, temperature, catecholamine and respiratory measurements for 60 min during three consecutive stages: baseline (10 min; 33 °C water through a thin-tubed whole-body suit), mild cold stress (20 min; 25 °C water), and post-cold recovery (30 min; 33 °C water). Static CA was determined as the ratio between mean changes in middle cerebral artery blood velocity and MAP, dynamic CA as transfer function coherence, gain, and phase between spontaneous changes in MAP to middle cerebral artery blood velocity.

RESULTS

MAP increased in both groups during cold and post-cold recovery (mean differences: 5-10 mm Hg; main effect of time: p = 0.001). Static CA was not different between the able-bodied vs. the cervical SCI group (mean (95% confidence interval (CI)) of between-group difference: -4 (-11 to 3) and -2 (-5 to 1) cm/s/mm Hg for cold (p = 0.22) and post-cold (p = 0.24), respectively). At baseline, transfer function phase was shorter in the cervical SCI group (mean (95% CI) of between-group difference: 0.6 (0.2 to 1.0) rad; p = 0.006), while between-group differences in changes in phase were not different in response to the cold stress (interaction term: p = 0.06).

CONCLUSIONS

This pilot study suggests that static CA is similar between individuals with cervical SCI and able-bodied controls in response to moderate increases in MAP, while dynamic CA may be impaired in cervical SCI because of disturbed sympathetic control.

Address: Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK. [email protected].; National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK. [email protected].; Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan.; Peter Harrison Centre for Disability Sport, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.; National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.; Human Health and Nutritional Sciences, Guelph University, Guelph, Ontario, Canada.; Department of Environmental Health, Nara Women's University, Nara, Japan.; Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan. [email protected].

DOI: 10.1038/s41393-017-0021-7

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https://doi.org/10.1038/s41393-017-0021-7

MeSH Terms: Adult, Blood Flow Velocity, Blood Pressure, Body Temperature, Cervical Cord, Cold Temperature, Epinephrine, Humans, Male, Middle Cerebral Artery, Norepinephrine, Pilot Projects, Respiration, Spinal Cord Injuries, Stress, Physiological