Autonomic dysreflexia: a cardiovascular disorder following spinal cord injury

查看全文 作　　者：Hisham [1]Sharif;Shaoping [1]Hou

机构地区：[1]Spinal Cord Research Center, Department of Neurobiology and Anatomy, Drexel University College of Medicine

出　　处：《Neural Regeneration Research》索引2017年第12卷第9期,共11页

基　　金：supported by NIH NINDS R01NS099076,Morton Cure Paralysis Funds(MCPF) 摘　　要：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. 关键词：心血管疾病脊髓损伤自主神经异常反射抗高血压药物临床治疗交感神经

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Autonomic dysreflexia: a cardiovascular disorder following spinal cord injury

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