Blood pressure dysfunction following spinal cord injury (SCI) decreases quality of life, delays rehabilitation, and is rated as a top priority for recovery for individuals with SCI. Non-invasive spinal cord stimulation (SCS) is a promising treatment to improve BP control. However, the best position to deliver this therapy along the spine, and the physiological mechanisms behind this therapy, remain unclear.
This study aims to compare the effects of mid-back and lower-back SCS on BP regulation in real time and after long-term stimulation (3x/week for 8 weeks). We will also investigate the mechanisms by which both real-time and long-term stimulation improves BP control. We will do this by performing analysis on heart rate and BP signals, and measure blood biomarkers. The results from this pilot clinical trial will provide the necessary evidence to conduct a larger multi-center clinical trial.
This award is co-funded by the Canadian Training Platform for Trials Leveraging Existing Networks (CAN-TAP-TALENT) and is a part of the Canadian Clinical Trials Platform competition.
End of Award Update – July 2025
Results
Blood pressure dysregulation is common after complete spinal cord injury and contributes to the decreased quality of life and increased mortality rates in this population. Our work showed that transcutaneous spinal cord stimulation over the lumbosacral and midthoracic spinal cord segments can help alleviate orthostatic hypotension (i.e., low blood pressure in upright position) in people with complete spinal cord injury, likely by modulating autonomic nervous system activity.
Impact
Our clinical trials with non-invasive spinal cord stimulation show that this therapy can help people with spinal cord injury regulate their blood pressure, which in turn improves their quality of life and ability to participate in activities of daily living. This may also lead to a reduced risk of cardiovascular disease following SCI.
Potential Influence
Given its non-invasive nature, ease of delivery, and effects on blood pressure regulation after SCI, transcutaneous spinal cord stimulation holds promise for integration into clinical rehabilitation to enhance functional recovery.
Next Steps
We are currently preparing this work for publication and have presented it at local and national conferences. We are also obtaining Health Canada approval to collect blood samples, before, during, and after spinal cord stimulation therapy, to better understand its effects on biomarkers of cardiovascular disease.
Useful Links
- Samejima S, Malik RN, Ge J, Rempel L, Cao K, Desai S, Shackleton C, Kyani A, Sarikhani P, D’Amico JM, Krassioukov AV. Cardiovascular safety of transcutaneous spinal cord stimulation in cervical spinal cord injury. Neurotherapeutics , date unknown. doi:10.1016/j.neurot.2025.e00528.
- Phillips AA, Squair JW, Sayenko DG, Edgerton VR, Gerasimenko Y, Krassioukov AV. An Autonomic Neuroprosthesis: Noninvasive Electrical Spinal Cord Stimulation Restores Autonomic Cardiovascular Function in Individuals with Spinal Cord Injury. J Neurotraum 35: 446–451, 2018. doi: 10.1089/neu.2017.5082.
- Samejima S, Shackleton C, Malik RN, Cao K, Bohorquez A, Nightingale TE, Sachdeva R, Krassioukov AV. Spinal Cord Stimulation Prevents Autonomic Dysreflexia in Individuals with Spinal Cord Injury: A Case Series. J Clin Medicine 12: 2897, 2023. doi: 10.3390/jcm12082897.