Observations of cold-induced vasodilation in persons with spinal cord injuries

Spinal Cord, 2024 · DOI: https://doi.org/10.1038/s41393-024-00960-3 · Published: February 22, 2024

Spinal Cord Injury Cardiovascular Science

Simple Explanation

This study investigates cold-induced vasodilation (CIVD) in individuals with spinal cord injuries (SCIs). CIVD is a process where skin blood flow increases during local cooling, potentially preventing frostbite. The researchers examined whether this increase in skin blood flow (SkBF) occurs in SCI patients and if it differs based on the injury location (cervical vs. thoracolumbar) or the body area being cooled (chest vs. thigh). The study found that SkBF increased during local cooling in both sensory-intact (chest) and sensory-impaired (thigh) areas of SCI patients, suggesting local mechanisms drive this response.

Study Duration

Not specified

Participants

18 participants: 9 with cervical SCIs (SCIC) and 9 with thoracolumbar SCIs (SCITL)

Evidence Level

Level 2: Acute experimental study

Key Findings

1
An increase in skin blood flow (SkBF) during local cooling (LC) was observed in both sensate (chest) and non-sensate (thigh) areas in individuals with spinal cord injuries (SCIs).
2
The magnitude of the SkBF increase was larger in the sensate area (chest) compared to the non-sensate area (thigh), suggesting that intact sensory nerves may influence the response.
3
The sympathetic nervous system appears to play a minor role in modifying the increased SkBF response, as responses between SCIC and SCITL groups did not differ significantly despite differences in sympathetic nerve integrity.

Research Summary

This study investigated cold-induced vasodilation (CIVD) in individuals with spinal cord injuries (SCIs) by measuring skin blood flow (SkBF) during local cooling (LC) on the chest and thigh. The results showed that SkBF increased during LC in both sensate and non-sensate areas, with a larger increase in the sensate area, indicating that intact sensory neurons might strengthen the response. The study suggests that local mechanisms, rather than central neural mechanisms, trigger the increased SkBF, implying that the defense mechanism against frostbite exists even in paralyzed areas.

Practical Implications

Potential for Frostbite Prevention

The finding that CIVD occurs even in paralyzed areas suggests a potential for developing strategies to prevent frostbite in individuals with SCIs.

Understanding Local Mechanisms

The study highlights the importance of local mechanisms in regulating skin blood flow in SCI patients, which could inform future research and interventions.

Sensory Nerve Influence

The greater response in sensate areas suggests that preserving or enhancing sensory nerve function could improve thermoregulation in SCI patients.

Study Limitations

1
Small sample size.
2
Variability in the time elapsed since injury remained unsolved.
3
Electrical activities related to indexes of skin sympathetic nervous activity were not measured.

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