Epidural electrical stimulation and hemodynamic control after spinal cord injury
Bibliographic record
Abstract
Spinal cord injury impairs cerebral autoregulation (i.e., the buffering of changes in blood pressure in an effort to maintain cerebral blood flow constant) and baroreflex sensitivity (i.e., the appropriate heart rate responses to changes in blood pressure), due in part to the disruption of supraspinal sympathetic control of circuits below the level of injury. This impairment is almost certainly associated with the greater risk of cerebrovascular and heart disease observed in this population. We have previously shown in people with spinal cord injury that epidural electrical stimulation of the spinal cord below the level of injury (eSTIM) activates disconnected sympathetic circuits. Furthermore, long‐term daily application of eSTIM can in some cases lead to plasticity that restores function, even when eSTIM is off. It is not clear if eSTIM activation of sympathetic circuits restores cerebral autoregulation and baroreflex function after spinal cord injury, or if functionally‐relevant plasticity occurs after long‐term application of eSTIM. Here, we show that activating eSTIM immediately improves cerebral autoregulation and baroreflex sensitivity. These positive immediate effects were repeatable over several months. Long‐term daily eSTIM for at least 12 weeks did not affect cerebral autoregulation or baroreflex function when stimulation was off, indicating that functionally‐relevant plasticity did not occur. In conclusion, immediate application of eSTIM may be a viable therapy for improving hemodynamic control after spinal cord injury. Support or Funding Information Natural Sciences and Engineering Research Council of Canada, Canadian Institutes of Health Research, Libin Cardiovascular Institute of Alberta, Hotchkiss Brain Institute, Compute Canada. Cerebral autoregulation was consistently improved with the activation of eSTIM as indicated by increased phase lag between blood pressure and cerebral blood flow. Cardiovagal baroreflex function was also improved as indicated by more rapid heart rate responses to changes in blood pressure. **indicates significant difference ( p <0.005) Figure 1
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".