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Cardiovagal baroreflex gain relates to sensory loss after spinal cord injury.
Auton Neurosci. 2020 07; 226:102667.AN

Abstract

Spinal cord injury (SCI) leads to autonomic nervous system damage, resulting in loss of sympathetic control to the vasculature and the heart proportional to injury level. Given maintained cardiac parasympathetic control, we hypothesized that SCI demonstrates a compensatory, higher baroreflex gain compared to able-bodied that relates to injury level (neurological and/or sensory). We compared baroreflex gain (average and across 10-20, 20-30, and 30-40 mmHg input stimuli) derived from neck chamber technique in SCI (N = 29; neurological level C1-T10, sensory zone of partial preservation C4-S4/5; ≤2 yrs since injury) and able-bodied (N = 14). Average gain tended to be higher in able-bodied compared to SCI (p = 0.06), primarily due to higher gains at 10-20 and 20-30 mmHg (p = 0.03, p = 0.06). In SCI, although gain was not related to neurological level, average gain and gain at 10-20 mmHg was related to sensory zone of partial preservation and resting RR-interval (all p < 0.02). Multiple regression showed that both sensory level and RR-interval were strongly predictive of average baroreflex gain (r2 = 0.41, p < 0.01) and gain at 10-20 mmHg (r2 = 0.51, p < 0.01); gain decreased with higher sensory zone of partial preservation and lower resting RR-interval. Moreover, gain was significantly lower in those with high sensory level compared to both able-bodied (average gain and gain at 10-20 and 20-30 mmHg p < 0.01) and those with low level injury (all p < 0.05). In SCI, sensory zone of partial preservation is more predictive of gain than neurological level. This might reflect that those with high level sensory injuries may have the lowest likelihood of intact cardiac sympathetic innervation and therefore lesser cardiac vagal responsiveness due to vagal-sympathetic interactions.

Authors+Show Affiliations

Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States of America; Cardiovascular Research Laboratory, Spaulding Hospital Cambridge, Cambridge, MA, United States of America. Electronic address: adraghici@mgh.harvard.edu.Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States of America; Cardiovascular Research Laboratory, Spaulding Hospital Cambridge, Cambridge, MA, United States of America.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32247945

Citation

Draghici, Adina E., and J Andrew Taylor. "Cardiovagal Baroreflex Gain Relates to Sensory Loss After Spinal Cord Injury." Autonomic Neuroscience : Basic & Clinical, vol. 226, 2020, p. 102667.
Draghici AE, Taylor JA. Cardiovagal baroreflex gain relates to sensory loss after spinal cord injury. Auton Neurosci. 2020;226:102667.
Draghici, A. E., & Taylor, J. A. (2020). Cardiovagal baroreflex gain relates to sensory loss after spinal cord injury. Autonomic Neuroscience : Basic & Clinical, 226, 102667. https://doi.org/10.1016/j.autneu.2020.102667
Draghici AE, Taylor JA. Cardiovagal Baroreflex Gain Relates to Sensory Loss After Spinal Cord Injury. Auton Neurosci. 2020;226:102667. PubMed PMID: 32247945.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovagal baroreflex gain relates to sensory loss after spinal cord injury. AU - Draghici,Adina E, AU - Taylor,J Andrew, Y1 - 2020/03/23/ PY - 2019/08/09/received PY - 2020/02/28/revised PY - 2020/03/21/accepted PY - 2021/07/01/pmc-release PY - 2020/4/6/pubmed PY - 2020/4/6/medline PY - 2020/4/6/entrez KW - Baroreflex gain KW - Neck chamber technique KW - Neurological level of injury KW - Sensory zone of partial preservation KW - Spinal cord injury SP - 102667 EP - 102667 JF - Autonomic neuroscience : basic & clinical JO - Auton Neurosci VL - 226 N2 - Spinal cord injury (SCI) leads to autonomic nervous system damage, resulting in loss of sympathetic control to the vasculature and the heart proportional to injury level. Given maintained cardiac parasympathetic control, we hypothesized that SCI demonstrates a compensatory, higher baroreflex gain compared to able-bodied that relates to injury level (neurological and/or sensory). We compared baroreflex gain (average and across 10-20, 20-30, and 30-40 mmHg input stimuli) derived from neck chamber technique in SCI (N = 29; neurological level C1-T10, sensory zone of partial preservation C4-S4/5; ≤2 yrs since injury) and able-bodied (N = 14). Average gain tended to be higher in able-bodied compared to SCI (p = 0.06), primarily due to higher gains at 10-20 and 20-30 mmHg (p = 0.03, p = 0.06). In SCI, although gain was not related to neurological level, average gain and gain at 10-20 mmHg was related to sensory zone of partial preservation and resting RR-interval (all p < 0.02). Multiple regression showed that both sensory level and RR-interval were strongly predictive of average baroreflex gain (r2 = 0.41, p < 0.01) and gain at 10-20 mmHg (r2 = 0.51, p < 0.01); gain decreased with higher sensory zone of partial preservation and lower resting RR-interval. Moreover, gain was significantly lower in those with high sensory level compared to both able-bodied (average gain and gain at 10-20 and 20-30 mmHg p < 0.01) and those with low level injury (all p < 0.05). In SCI, sensory zone of partial preservation is more predictive of gain than neurological level. This might reflect that those with high level sensory injuries may have the lowest likelihood of intact cardiac sympathetic innervation and therefore lesser cardiac vagal responsiveness due to vagal-sympathetic interactions. SN - 1872-7484 UR - https://www.unboundmedicine.com/medline/citation/32247945/Cardiovagal_baroreflex_gain_relates_to_sensory_loss_after_spinal_cord_injury L2 - https://linkinghub.elsevier.com/retrieve/pii/S1566-0702(19)30196-1 DB - PRIME DP - Unbound Medicine ER -
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