RecruitingNot ApplicableNCT07210411

Acute and Chronic Repercussion of Spinal Cord Stimulation After Spinal Cord Injury


Sponsor

Mayo Clinic

Enrollment

80 participants

Start Date

Mar 5, 2026

Study Type

INTERVENTIONAL

Conditions

Summary

The purpose of this research is to learn about how the participant's body is able to balance changes in blood pressure, and how spinal cord stimulation affects these changes as well as immune \& cardiovascular function in participants with spinal cord injury.


Eligibility

Min Age: 18 YearsMax Age: 50 Years

Inclusion Criteria6

  • Age 18-50.
  • American Spinal Injury Association Impairment Scale A-D,64 to encompass a representational spectrum of autonomic dysfunction after spinal cord injury.
  • Neurological level of injury, C6-T8, as defined by the International Standards for Neurological Classification of Spinal Cord Injury.64 Incorporating level of injury over this broad range to capture the spectrum of autonomic dysfunction. Individuals with injuries below T8 will not be included to ensure transcutaneous spinal cord stimulation does not occur over the injury/glial scar, where it may have altered properties. The C6 level was chosen to ensure hand cold pressor stimuli triggers above level sympathetic activation.
  • Time since injury of greater than six months, given early changes in spinal cord connectivity and recovery prior to this.
  • Both individuals with and without currently implanted epidural spinal cord stimulators will be enrolled.
  • Twenty uninjured controls will also be enrolled.

Exclusion Criteria7

  • History of clinically diagnosed cardiovascular disease, diabetes, autonomic neuropathies, neurological disorders (with exception of spinal cord injury for individuals in those cohorts), or are active smokers.
  • Individuals who are taking betablockers, antihypertensives, or other sympathetically active medications which they are unable to hold.
  • Women who are pregnant or lactating, given known hormonal influences on autonomic regulation.65,66
  • Cognitive issues preventing informed consent for participation.
  • Body mass index >30 kg/m2 for the uninjured controls only given increased risk of prediabetes and potential confounding normative values.
  • taking or being administered a medication known to potentially have adverse interactions with phenylephrine
  • in the judgement of the principal investigator, any illness or condition that will interfere with the patient's ability to comply with the protocol, compromise patient safety, or interfere with the interpretation of the study results

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Interventions

DIAGNOSTIC_TESTTests of sympathetic inhibition

Bolus phenylephrine infusion using the Oxford technique will generate the need to inhibit sympathetic activity. Similarly, resting state Mayer waves will be assessed with regard to heart rate and blood pressure responses.

DIAGNOSTIC_TESTTests of above level sympathetic activation

Cold pressor test of the hand will be used to cause sympathetic activation. Valsalva's maneuver will assess the ability to buffer against blood pressure fall (phase II).

DIAGNOSTIC_TESTTesting of below level sympathetic activation

Cold pressor test of the foot and bladder pressor response (in individuals with SCI) will be tested.

DEVICEEpidural stimulation

Currently implanted epidural stimulation will be used during diagnostic testing.

DEVICETranscutaneous stimulation

Transcutaneous stimulation will be used for participants with spinal cord injury without an implanted stimulator during diagnostic testing.


Locations(1)

Mayo Clinic

Rochester, Minnesota, United States

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NCT07210411


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