Orthostatic hypotension following spinal cord injury: Understanding clinical pathophysiology

Spinal Cord

Volumn 44, Issue 6, 2006, Pages 341-351

  Claydon, V E ^a   Steeves, J D ^a   Krassioukov, A ^a  

^a UNIVERSITY OF BRITISH COLUMBIA   (Canada)

Author keywords

Orthostatic hypotension; Spinal cord injury

Indexed keywords

FLUDROCORTISONE; MIDODRINE;

ADRENERGIC SYSTEM; AUTOREGULATION; BLOOD PRESSURE REGULATION; BRAIN PERFUSION; CARDIOVASCULAR EFFECT; CARDIOVASCULAR MALFORMATION; COMMON CAROTID ARTERY; DISEASE CLASSIFICATION; ELECTROLYTE BALANCE; FLUID INTAKE; HEMODYNAMICS; HUMAN; INCIDENCE; MUSCLE CONTRACTION; NEUROANATOMY; NEUROLOGIC DISEASE; NEUROPHYSIOLOGY; ORTHOSTATIC HYPOTENSION; PATHOPHYSIOLOGY; POSTPRANDIAL STATE; PRESSORECEPTOR REFLEX; PREVALENCE; PRIORITY JOURNAL; PROTECTIVE CLOTHING; REVIEW; SALT INTAKE; SPINAL CORD INJURY;

BAROREFLEX; BLOOD PRESSURE; HEART; HUMANS; HYPOTENSION, ORTHOSTATIC; SPINAL CORD; SPINAL CORD INJURIES;

EID: 33744994771     PISSN: 13624393     EISSN: 14765624     Source Type: Journal    
DOI: 10.1038/sj.sc.3101855     Document Type: Review

References (95)

1. Ackery A, Tator C, Krassioukov A. A global perspective on spinal cord injury epidemiology. J Neurotrauma 2004; 21: 1355-1370.
2. Calaresu FR, Yardley CP. Medullary basal sympathetic tone. Ann Rev Physiol 1988; 50: 511-524.
3. Osborn JW, Taylor RF, Schramm LP. Determinants of arterial pressure after chronic spinal transection in rats. Am J Physiol 1989; 256: R666-R673.
4. Krassioukov AV, Weaver LC. Episodic hypertension due to autonomic dysreflexia in acute and chronic spinal cord-injured rats. Am J Physiol 1995; 268: H2077-H2083.
5. Maiorov DN, Fehlings MG, Krassioukov AV. Relationship between severity of spinal cord injury and abnormalities in neurogenic cardiovascular control in conscious rats. J Neurotrauma 1998; 15: 365-374.
6. Mathias CJ, Frankel HL. Autonomic disturbances in spinal cord lesions. In: Mathias CJ, Bannister R (eds). Autonomic Failure: A Textbook of Clinical Disorders of the Autonomic Nervous System, 4th edn. Oxford University Press: Oxford 2002, pp 494-513.
7. Osborn JW, Taylor RF, Schramm LP. Chronic cervical spinal cord injury and autonomic hyperreflexia in rats. Am J Physiol 1990; 8: R169-R174.
8. Teasell RW, Arnold MO, Krassioukov A, Delaney G. Cardiovascular consequences of loss of supraspinal control of the sympathetic nervous system after spinal cord injury. Arch Phys Med Rehab 2000; 81: 506-516.
9. Krum H et al. Risk factors for cardiovascular disease in chronic spinal cord injury patients. Paraplegia 1992; 30: 381-388.
10. Devivo MJ, Krause JS, Lammertse DP. Recent trends in mortality and causes of death among persons with spinal cord injury. Arch Phys Med Rehabil 1999; 80: 1411-1419.
11. Garshick E et al. A prospective assessment of mortality in chronic spinal cord injury. Spinal Cord 2005; 43: 408-416.
12. Verberne AJ, Owens NC. Cortical modulation of the cardiovascular system. Prog Neurobiol 1998; 54: 149-168.
13. Krassioukov AV, Weaver LC. Anatomy of the autonomic nervous system. Phys Med Rehabil 1996; 10: 1-14.
14. Krassioukov AV, Fehlings MG. Effect of graded spinal cord compression on cardiovascular neurons in the rostroventrolateral medulla. Neuroscience 1999; 88: 959-973.
15. Lebedev VP, Krasyukov AV, Nikitin SA. Electrophysiological study of sympathoexcitatory structures of the bulbar ventrolateral surface as related to vasomotor regulation. Neurosci 1986; 17: 189-203.
16. Reis DJ, Morrison S, Ruggierdo DA. The C1 area of the brainstem in tonic and reflex control of blood pressure. Hypertension 1988; 11: I8-I13.
17. Shepherd RFJ, Shepherd JT. Central nervous control of the cardiovascular system. In: Bannister R, Mathias CJ (eds). Autonomic Failure: A Textbook of Clinical Disorders of the Autonomic Nervous System, 4th edn. Oxford University Press: Oxford 2002, pp 54-93.
18. Furlan JC, Fehlings MG, Shannon P, Norenberg MD, Krassioukov AV. Descending vasomotor pathways in humans: correlation between axonal preservation and cardiovascular dysfunction after spinal cord injury. J Neurotrauma 2003; 20: 1351-1363.
19. Ditunno JF, Little JW, Tessler A, Burns AS. Spinal shock revisited: a four-phase model. Spinal Cord 2004; 42: 383-395.
20. Atkinson PP, Atkinson JLD. Spinal shock. Mayo Clin Proc 1996; 71: 384-389.
21. Mathias CJ, Mallipeddi R, Bleasdale-Barr K. Symptoms associated with orthostatic hypotension in pure autonomic failure and multiple system atrophy. J Neurol 1999; 246: 893-898.
22. Mathias CJ, Frankel HL. Clinical manifestations of malfunctioning sympathetic mechanisms in tetraplegia. J Auton Nerv Syst 1983; 7: 303-312.
23. Krassioukov AV, Furlan JC, Fehlings MG. Autonomic dysreflexia in acute spinal cord injury: an under-recognised clinical entity. J Neurotrauma 2003; 20: 707-715.
24. Silver JR. Early autonomic dysreflexia. Spinal Cord 2000; 38: 229-233.
25. Frisbie JH, Steele DJR. Postural hypotension and abnormalities of salt and water metabolism in myelopathy patients. Spinal Cord 1997; 35: 303-307.
26. Claus-Walker J, Halstead LS. Metabolic and endocrine changes in spinal cord injury: II (section 1). Consequences of partial decentralization of autonomic nervous system. Arch Phys Med Rehab 1982; 63: 569-575.
27. Maiorov DN, Weaver LC, Krassioukov AV. Relationship between sympathetic activity and arterial pressure in conscious spinal rats. Am J Physiol 1997; 272: H625-H631.
28. Wallin BG, Stiernberg L. Sympathetic activity in man after spinal cord injury. Brain 1984; 107: 183-198.
29. Krassioukov AV, Bunge RP, Puckett WR, Bygrave MA. The changes in human spinal cord sympathetic preganglionic neurons after spinal cord injury. Spinal Cord 1999; 37: 6-13.
30. Krassioukov AV, Weaver LC. Morphological changes in sympathetic preganglionic neurons after spinal cord injury in rats. Neuroscience 1996; 70: 211-225.
31. Krassioukov AV, Johns DG, Schramm LP. Sensitivity of sympathetically correlated spinal interneurons, renal sympathetic nerve activity, and arterial pressure to somatic and visceral stimuli after chronic spinal injury. J Neurotrauma 2002; 19: 1521-1529.
32. Krenz NR, Weaver LC. Sprouting of primary afferent fibers after spinal cord transection in the rat. Neuroscience 1998; 85: 443-458.
33. Krenz NR, Meakin SO, Krassioukov AV, Weaver LC. Neuralizing intraspinal nerve growth factor blocks autonomic dysreflexia caused by spinal cord injury. J Neuroscience 1999; 19: 7405-7414.
34. Arnold JM, Feng QP, Delaney GA, Teasell RW. Autonomic dysreflexia in tetraplegic patients: evidence for alpha-adrenoceptor hyper-responsiveness. Clin Auton Res 1995; 5: 267-270.
35. The Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. Neurology 1996; 46: 1470.
36. Lopes P, Figoni S. Current literature on orthostatic hypotension and training in SCI patients. Am Correct Ther 1982; 36: 893-898.
37. Blackmer J. Orthostatic hypotension in spinal cord injured patients. J Spinal Cord Med 1997; 20: 212-217.
38. Illman A, Stiller K, Williams M. The prevalence of orthostatic hypotension during physiotherapy treatment in patients with an acute spinal cord injury. Spinal Cord 2000; 38: 741-747.
39. McKinley WO, Tewksbury MA, Godbout CJ. Comparison of medical complication following non-traumatic and traumatic spinal cord injury. J Spinal Cord Med 2002; 25: 88-93.
40. Cariga P, Ahmed S, Mathias CJ, Gardner BP. The prevalence and association of neck (coat hanger) pain and orthostatic (postural) hypotension in human spinal cord injury. Spinal Cord 2002; 40: 77-82.
41. Kenny RA. Syncope in the elderly: diagnosis, evaluation and treatment. J Cardiovasc Electrophysiol 2003; 14: S74-S77.
42. Krassioukov AV, Furlan JC, Fehlings MG. Medical co-morbidities, secondary complications and mortality in elderly with acute spinal cord injury. J Neurotrauma 2003; 20: 391-399.
43. Calancie B, Molano MR, Broton JG. Epidemiology and demography of acute spinal cord injury in a large urban setting. J Spinal Cord Med 2005; 28: 92-96.
44. Krassioukov AV, Elliott S, Claydon VE. Cardiovascular responses to a 'sit up test' in men with cervical spinal cord injury. Clin Auton Res 2005; 15: 334.
45. Maynard FM et al. International standards for neurological and functional classification of spinal cord injury. Spinal Cord 1997; 35: 266-274.
46. Brown CM, Hainsworth R. Forearm vascular responses during orthostatic stress in control subjects and patients with posturally related syncope. Clin Auton Res 2000; 10: 57-61.
47. Bush VE, Wight VL, Brown CM, Hainsworth R. Vascular responses to orthostatic stress in patients with postural tachycardia syndrome (POTS), in patients with low orthostatic tolerance, and in asymptomatic controls. Clin Auton Res 2000; 10: 279-284.
48. Claydon VE, Hainsworth R. Salt supplementation improves orthostatic cerebral and peripheral vascular control in patients with syncope. Hypertension 2004; 43: 1-5.
49. Raymond J, Davis GM, Bryant G, Clarke J. Cardiovascular responses to an orthostatic challenge and electrical-stimulation-induced leg muscle contractions in individuals with paraplegia. Eur J Appl Physiol Occup Physiol 1999; 80: 205-212.
50. Faghri PD, Yount JP, Pesce WJ, Seetharama S, Vootto JJ. Circulatory hypokinesis and functional electric stimulation during standing in persons with spinal cord injury. Arch Phys Med Rehabil 2001; 82: 1587-1595.
51. Faghri PD, Yount J. Electrically induced and voluntary activation of physiologic muscle pump: a comparison between spinal cord-injured and able-bodied individuals. Clin Rehab 2002; 16: 878-885.
52. Wall BM et al. Characteristics of vasopressin release during controlled reduction in arterial pressure. J Lab Clin Med 1994; 124: 554-563.
53. Mathias CJ, Christensen NJ, Corbett JL, Frankel HL, Goodwin TJ, Peart WS. Plasma catecholamines, plasma renin activity and plasma aldosterone in tetraplegic man, horizontal and tilted. Clin Sci Mol Med 1975; 49: 291-299.
54. Mathias CJ, Christensen NJ, Frankel HL, Peart WS. Renin release during head-up tilt occurs independently of sympathetic nervous activity in tetraplegic man. Clin Sci 1980; 59: 251-256.
55. Ellaway PH et al. Towards improved clinical and physiological assessments of recovery in spinal cord injury: a clinical initiative. Spinal Cord 2004; 42: 325-337.
56. Krum H, Louis WJ, Brown DJ, Jackman GP, Howes LG. Diurnal blood pressure variation in quadraplegic chronic spinal cord injury patients. Clin Sci 1991; 80: 271-276.
57. Mayorov DN, Adams MA, Krassioukov AV. Telemetric blood pressure monitoring in conscious rats before and after compression injury of the spinal cord. J Neurotrauma 2001; 18: 727-736.
58. Munakata M, Kameyama J, Kanazawa M, Nunokawa T, Moriai N, Yoshinaga K. Circadian blood pressure rhythm in patients with higher and lower spinal cord injury: simultaneous evaluation of autonomic nervous activity and physical activity. J Hypertens 1997; 15: 1745-1749.
59. Conway J, Boon N, Jones JV, Sleight P. Involvement of the baroreceptor reflexes in the changes in blood pressure with sleep and mental arousal. Hypertension 1983; 5: 746-748.
60. Nakazato T, Shikama T, Toma S, Nakajima Y, Masuda Y. Nocturnal variation in human sympathetic baroreflex sensitivity. J Auton Nerv Sys 1998; 70: 32-37.
61. Makino M, Hayashi H, Takezawa H, Hirai M, Saito H, Ebihara S. Circadian rhythms of cardiovascular functions are modulated by the baroreflex and the autonomic nervous sustem in the rat. Circulation 1997; 96: 1667-1674.
62. Munakata M, Kameyama J, Nunokawa T, Ito N, Yoshinaga K. Altered Mayer wave and baroreflex profiles in high spinal cord injury. Am J Hypertens 2001; 14: 141-148.
63. Convertino VA, Adams WC, Shea JD, Thompson CA, Hoffler GW. Impairment of carotid-cardiac vagal baroreflex in wheelchair-dependent quadriplegics. Am J Physiol 1991; 260: R576-R580.
64. Wecht JM, de Meersman RE, Weir JP, Spungen AM, Bauman WA. Cardiac autonomic responses to progressive head-up tilt in individuals with paraplegia. Clin Auton Res 2004; 13: 433-438.
65. El-Bedawi KM, Hainsworth R. Combined head up tilt and lower body suction - a test of orthostatic tolerance. Clin Auton Res 1994; 4: 41-47.
66. El-Sayed H, Hainsworth R. Relationship between plasma volume, carotid baroreceptor sensitivity and orthostatic tolerance. Clin Sci 1995; 88: 463-470.
67. Guyton AC, Richardson TQ, Langston JB. Regulation of cardiac output and venous return. Clin Anesth 1964; 3: 1-34.
68. Graveline DE. Cardiovascular deconditioning: role of blood volume and sympathetic neurohormones. Life Sci Space Res 1964; 2: 287-298.
69. Vaziri ND. Nitric oxide in microgravity-induced orthostatic intolerance: relevance to spinal cord injury. J Spinal Cord Med 2003; 26: 5-11.
70. Ignarro LJ, Buga GM, Wood KS, Byrns RE, Chaudhuri G. Endothelium-derived relaxing factor produced and released from artery and vein is nitric oxide. Proc Natl Acad Sci USA 1987; 84: 9265-9269.
71. Claydon VE et al. Orthostatic tolerance and blood volumes in Andean high altitude dwellers. Exp Physiol 2004; 89: 565-571.
72. Mtinangi BL, Hainsworth R. Early effects of oral salt on plasma volume, orthostatic tolerance and baroreceptor sensitivity in patients with syncope. Clin Auton Res 1998; 8: 231-235.
73. El-Sayed H, Hainsworth R. Salt supplement increases plasma volume and orthostatic tolerance in patients with unexplained syncope. Heart 1996; 75: 134-140.
74. Frisbie JH. Postural hypotension, hyponatremia, and salt and water intake: case reports. J Spinal Cord Med 2004; 27: 133-137.
75. Karlsson AK, Krassioukov AV. Hyponatremia-induced transient visual disturbances in acute spinal cord injury. Spinal Cord 2004; 42: 204-207.
76. Soni BM, Vaidyanthan S, Watt JWH, Krishman KR. A retrospective study of hyponatremia in tetraplegic paraplegic patients with a review of the literature. Paraplegia 1994; 32: 597-607.
77. Bondar RL et al. Cerebrovascular and cardiovascular responses to graded tilt in patients with autonomic failure. Stroke 1997; 28: 1677-1685.
78. Horowitz DR, Kaufmann H. Autoregulatory cerebral vasodilatation occurs during orthostatic hypotension in patients with primary autonomic failure. Clin Auton Res 2001; 11: 363-367.
79. Hetsel A, Reinhard M, Guschlbauer B, Braune S. Challenging cerebral autoregulation in patients with preganglionic autonomic failure. Clin Auton Res 2003; 13: 27-35.
80. Hainsworth R. Syncope and fainting. In: Mathias CJ, Bannister R (eds). Autonomic Failure: A Textbook of Clinical Disorders of the Autonomic Nervous System, 4th edn. Oxford University Press: Oxford 2002, pp 761-781.
81. Gonzalez F, Chang JY, Banovac K, Messina D, Martinez-Arizala A, Kelley RE. Autoregulation of cerebral blood flow in patients with orthostatic hypotension after spinal cord injury. Paraplegia 1991; 29: 1-7.
82. Houtman S, Serrador JM, Colier JM, Strijbos DW, Shoemaker K, Hopman MTE. Changes in cerebral oxygenation and blood flow during LBNP in spinal cord-injured individuals. J Appl Physiol 2001; 91: 2199-2204.
83. Houtman S, Colier WN, Oeseburg B, Hopman MT. Systemic circulation and cerebral oxygenation during head-up tilt in spinal cord injured individuals. Spinal Cord 2000; 38: 158-163.
84. Wecht JM, Radulovic M, Lessey J, Spungen AM, Bauman WA. Common carotid and common femoral arterial dynamics during head-up tilt in persons with spinal cord injury. J Rehab Res Dev 2004; 41: 89-94.
85. Duschek S, Weisz N, Schandry R. Reduced cognitive performance and prolonged reaction time accompany moderate hypotension. Clin Auton Res 2003; 13: 427-432.
86. Wessely S, Nickson J, Cox B. Symptoms of low blood pressure: a population study. BMJ 1990; 301: 362-365.
87. Freeman R. Treatment of orthostatic hypotension. Semin Neurol 2003; 23: 435-442.
88. Boyd GW. Stress and disease: the missing link. A vasospastic theory. II The nature of degenerative arterial disease. Med Hypotheses 1978; 4: 420-431.
89. Johansson BB. Hypertension mechanisms causing stroke. Clin Exp Pharm Physiol 1999; 26: 563-565.
90. Bannister R, Mathias CJ. The management of postural hypotension. In: Mathias CJ, Bannister R (eds). Autonomic Failure: A Textbook of Clinical Disorders of the Autonomic Nervous System, 4th edn. Oxford University Press: Oxford 2002, pp 622-645.
91. Mathias CJ. Autonomic diseases: management. J Neurol Sureosurg Psychiatry 2003; 74: iii42-iii47.
92. Ten Harkel AD, Van Lieshout JJ, Wieling W. Treatment of orthostatic hypotension with sleeping in the head-up tilt position, alone and in combination with fludrocortisone. J Intern Med 1992; 232: 139-145.
93. Groomes TE, Huang CT. Orthostatic hypotension after spinal cord injury: treatment with fludrocortisone and ergotamine. Arch Phys Med Rehabil 1991; 72: 56-58.
94. Mukand J, Karlin L, Barrs K, Lublin P. Midodrine for the management of orthostatic hypotension in patients with spinal cord injury: a case report. Arch Phys Med Rehabil 2001; 82: 694-696.
95. Barber DB, Rogers SJ, Fredrickson MD, Able AC. Midorine hydrochloride and the treatment of orthostatic hypotension in tetraplegia: two cases and a review of the literature. Spinal Cord 2000; 38: 109-111.