The blood pressure pendulum following spinal cord injury: implications for vascular cognitive impairment

Research output: Contribution to journalReview articlepeer-review

Authors

External organisations

  • International Collaboration On Repair Discoveries (ICORD)
  • Faculty of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver
  • GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver

Abstract

Cognitive impairment following spinal cord injury (SCI) has received considerable attention in recent years. Among the various systemic effects of SCI that contribute towards cognitive decline in this population, cardiovascular dysfunction is arguably one of the most significant. The majority of individuals with a cervical or upper-thoracic SCI commonly experience conditions called orthostatic hypotension and autonomic dysreflexia, which are characterized by dangerous fluctuations in systemic blood pressure (BP). Herein, we review the potential impact of extreme BP lability on vascular cognitive impairment (VCI) in individuals with SCI. Albeit preliminary in the SCI population, there is convincing evidence that chronic hypotension and hypertension in able-bodied individuals results in devastating impairments in cerebrovascular health, leading to VCI. We discuss the pertinent literature, and while drawing mechanistic comparisons between able-bodied cohorts and individuals with SCI, we emphasize the need for additional research to elucidate the mechanisms of cognitive impairment specific to the SCI population. Lastly, we highlight the current and potential future therapies to manage and treat BP instability, thereby possibly mitigating VCI in the SCI population.

Details

Original languageEnglish
Article number2464
Number of pages8
JournalInternational Journal of Molecular Sciences
Volume20
Issue number10
Publication statusPublished - 18 May 2019
Externally publishedYes

Keywords

  • spinal cord injury, vascular cognitive impairment, orthostatic hypotension, autonomic dysreflexia