Autonomic dysreflexia: a cardiovascular disorder following spinal cord injury
Autonomic dysreflexia (AD) is a serious cardiovascular disorder in patients with spinal cord injury (SCI). The primary underlying cause of AD is loss of supraspinal control over sympathetic preganglionic neurons (SPNs) caudal to the injury, which renders the SPNs hyper-responsive to stimulation. Cen...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2017-01-01
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| Series: | Neural Regeneration Research |
| Subjects: | |
| Online Access: | http://www.nrronline.org/article.asp?issn=1673-5374;year=2017;volume=12;issue=9;spage=1390;epage=1400;aulast=Sharif |
| _version_ | 1819014157438025728 |
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| author | Hisham Sharif Shaoping Hou |
| author_facet | Hisham Sharif Shaoping Hou |
| author_sort | Hisham Sharif |
| collection | DOAJ |
| description | Autonomic dysreflexia (AD) is a serious cardiovascular disorder in patients with spinal cord injury (SCI). The primary underlying cause of AD is loss of supraspinal control over sympathetic preganglionic neurons (SPNs) caudal to the injury, which renders the SPNs hyper-responsive to stimulation. Central maladaptive plasticity, including C-fiber sprouting and propriospinal fiber proliferation exaggerates noxious afferent transmission to the SPNs, causing them to release massive sympathetic discharges that result in severe hypertensive episodes. In parallel, upregulated peripheral vascular sensitivity following SCI exacerbates the hypertensive response by augmenting gastric and pelvic vasoconstriction. Currently, the majority of clinically employed treatments for AD involve anti-hypertensive medications and Botox injections to the bladder. Although these approaches mitigate the severity of AD, they only yield transient effects and target the effector organs, rather than addressing the primary issue of central sympathetic dysregulation. As such, strategies that aim to restore supraspinal reinnervation of SPNs to improve cardiovascular sympathetic regulation are likely more effective for AD. Recent pre-clinical investigations show that cell transplantation therapy is efficacious in reestablishing spinal sympathetic connections and improving hemodynamic performance, which holds promise as a potential therapeutic approach. |
| first_indexed | 2024-12-21T02:11:23Z |
| format | Article |
| id | doaj.art-dc7775b2adce4cee978c5c5dee4de02e |
| institution | Directory Open Access Journal |
| issn | 1673-5374 |
| language | English |
| last_indexed | 2024-12-21T02:11:23Z |
| publishDate | 2017-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Neural Regeneration Research |
| spelling | doaj.art-dc7775b2adce4cee978c5c5dee4de02e2022-12-21T19:19:21ZengWolters Kluwer Medknow PublicationsNeural Regeneration Research1673-53742017-01-011291390140010.4103/1673-5374.215241Autonomic dysreflexia: a cardiovascular disorder following spinal cord injuryHisham SharifShaoping HouAutonomic dysreflexia (AD) is a serious cardiovascular disorder in patients with spinal cord injury (SCI). The primary underlying cause of AD is loss of supraspinal control over sympathetic preganglionic neurons (SPNs) caudal to the injury, which renders the SPNs hyper-responsive to stimulation. Central maladaptive plasticity, including C-fiber sprouting and propriospinal fiber proliferation exaggerates noxious afferent transmission to the SPNs, causing them to release massive sympathetic discharges that result in severe hypertensive episodes. In parallel, upregulated peripheral vascular sensitivity following SCI exacerbates the hypertensive response by augmenting gastric and pelvic vasoconstriction. Currently, the majority of clinically employed treatments for AD involve anti-hypertensive medications and Botox injections to the bladder. Although these approaches mitigate the severity of AD, they only yield transient effects and target the effector organs, rather than addressing the primary issue of central sympathetic dysregulation. As such, strategies that aim to restore supraspinal reinnervation of SPNs to improve cardiovascular sympathetic regulation are likely more effective for AD. Recent pre-clinical investigations show that cell transplantation therapy is efficacious in reestablishing spinal sympathetic connections and improving hemodynamic performance, which holds promise as a potential therapeutic approach.http://www.nrronline.org/article.asp?issn=1673-5374;year=2017;volume=12;issue=9;spage=1390;epage=1400;aulast=Sharifautonomic dysreflexia; hyper-reflexia; sympathetic dysfunction; C-fibers; propriospinal axons; α-adrenoceptors; stem cell transplantation |
| spellingShingle | Hisham Sharif Shaoping Hou Autonomic dysreflexia: a cardiovascular disorder following spinal cord injury Neural Regeneration Research autonomic dysreflexia; hyper-reflexia; sympathetic dysfunction; C-fibers; propriospinal axons; α-adrenoceptors; stem cell transplantation |
| title | Autonomic dysreflexia: a cardiovascular disorder following spinal cord injury |
| title_full | Autonomic dysreflexia: a cardiovascular disorder following spinal cord injury |
| title_fullStr | Autonomic dysreflexia: a cardiovascular disorder following spinal cord injury |
| title_full_unstemmed | Autonomic dysreflexia: a cardiovascular disorder following spinal cord injury |
| title_short | Autonomic dysreflexia: a cardiovascular disorder following spinal cord injury |
| title_sort | autonomic dysreflexia a cardiovascular disorder following spinal cord injury |
| topic | autonomic dysreflexia; hyper-reflexia; sympathetic dysfunction; C-fibers; propriospinal axons; α-adrenoceptors; stem cell transplantation |
| url | http://www.nrronline.org/article.asp?issn=1673-5374;year=2017;volume=12;issue=9;spage=1390;epage=1400;aulast=Sharif |
| work_keys_str_mv | AT hishamsharif autonomicdysreflexiaacardiovasculardisorderfollowingspinalcordinjury AT shaopinghou autonomicdysreflexiaacardiovasculardisorderfollowingspinalcordinjury |