Prolonged Targeted Cardiovascular Epidural Stimulation Improves Immunological Molecular Profile: A Case Report in Chronic Severe Spinal Cord Injury

Severe spinal cord injury can disrupt the autonomic nervous system, leading to cardiovascular issues like blood pressure instability. This can increase the risk of stroke and systemic inflammation. The study explores whether cardiovascular-targeted epidural stimulation (CV-scES) can improve both cardiovascular stability and immune function. The case report focuses on a female with chronic cervical SCI who underwent 97 sessions of CV-scES. The study monitored the effects of this stimulation on blood pressure, cerebral blood flow, and gene expression related to immune function. The study found that CV-scES improved orthostatic tolerance and increased cerebral blood flow. Additionally, gene expression analysis suggested a down-regulation of inflammatory pathways and an up-regulation of adaptive immune pathways.

• 1
  Orthostatic tolerance improved significantly, from 10 minutes pre-CV-scES to the full 30 minutes post-CV-scES during a head-up tilt test.
• 2
  Improved orthostatic tolerance was associated with increased cerebral mean arterial pressure (cMAP) and mean cerebral blood flow velocity (mCBFv).
• 3
  Gene expression analysis revealed downregulation of pro-inflammatory genes and upregulation of genes related to adaptive immunity after CV-scES.