Spinal cord stimulation and cerebral haemodynamics

Abstract

An increase of regional cerebral blood flow (rCBF) has been shown to occur in man during spinal cord stimulation (SCS) by Hosobuchi (1986) and by Meglio et al. (1988) using the 133-Xenon wash-out technique. In this paper we report the effects of SCS on CBF as measured by two different techniques: 8 patients were studied with the 133-Xe method and 28 with the transcranial doppler sonography (TCD), in two cases both studies were performed. The aim of our study was to: 1-verify the effect of SCS on CBF, 2-compare observations made by two different methods, and 3-evaluate a possible correlation between the stimulated spinal segmental level and the modification of CBF. The results of our study confirm that SCS interacts with the mechanisms of regulation of CBF. The stimulation of different spinal cord levels in the same patient can produce different effects and such effects are reproducible. An increase of CBF is more likely to occur with the stimulation of the cervical spinal cord. In patients studied by both methods the sign of CBF changes induced by SCS was the same. Finally, in two patients the effect of SCS on CO2 autoregulation was studied with TCD. The results of such a study, although preliminary, suggest that CO2 and SCS have a competitive effect upon the mechanisms of regulation of CBF.

Spinal Cord Stimulation Prevents the Effects of Combined Experimental Ischemic and Traumatic Brain Injury

“…After the first observation published by Hosobuchi of an increase in CBF during cervical SCS in man [6], we confirmed his clinical report by utilizing the same 133 Xe inhalation technique and using transcranial Doppler sonography [7,8]. Subsequently experimental data concerning SCS induced CBF changes in animals were studied by Garcia-March, our group and Isono by means of electromagnetic flowmetry, Doppler sonography and hydrogen clearance method.…”

“…Spinal cord stimulation (SCS) interferes with the mechanisms of regulation of the cardiovascular and cerebro-vascular systems [1][2][3]. After demonstrating that SCS increases cerebral blood flow (CBF) in man and in animals we have shown a preventing effect of SCS on experimental 'early spasm' in the rabbit [4].…”

Roles of dorsal column pathway and transient receptor potential vanilloid type 1 in augmentation of cerebral blood flow by upper cervical spinal cord stimulation in rats

“…Hosobuchi (1985) was the first to report that cervical SCS (cSCS) produced an increase in cerebral blood flow (CBF) in humans. Subsequent clinical observations demonstrated that cSCS decreases cerebral vascular resistance and increases blood flow velocity, leading to an enhancement of the local-regional delivery of oxygen Mazzone et al 1996;Meglio et al, 1991a, b). Therefore, the promising results of SCSinduced CBF augmentation have led some clinicians to use this procedure to treat various cerebral vascular disorders.…”

“…Therefore, the promising results of SCSinduced CBF augmentation have led some clinicians to use this procedure to treat various cerebral vascular disorders. These cerebral diseases and/or pathological conditions include cerebral ischemia (Broseta et al, 1994;De Andres et al, 2007;Hosobuchi, 1991), ischemic spastic hemiparesis (Visocchi et al, 1994), focal cerebral ischemia (Meglio et al, 1991a, b;Ebel et al, 2001;Sagher et al, 2003;Sagher and Huang 2006;Robaina et al, 2004), cerebral vasospasm Karadag et al, 2005;Visocchi et al, 2001), stroke (Hosobuchi, 1991;Matsui and Hosobuchi, 1989;Visocchi et al, 1994Visocchi et al, , 2001, ischemic cerebral oedema (Gonzalez-Darder and Canadas-Rodriguez, 1991), postapoplectic spastic hemiplegia (Nakamura and Tsubokawa, 1985), prolonged coma (Fujii et al, 1998), persistent vegetative state (Funahashi et al 1989;Kanno et al, 1987;Kuwata, 1993), as well as migraine and posttraumatic cervicogenic headache (Dario et al, 2005). However, the underlying mechanisms of blood flow improvement are not well understood ).…”

Neuromodulation of Vegetative State through Spinal Cord Stimulation: Where Are We Now and Where Are We Going?

“…SCS has been shown to augment CBF and speculated to protect the brain from focal ischemia in a large series of experiments, both on animals and on humans [47,48,49,50,51,52,53], and has been proposed for the treatment of several cerebral low-perfusion syndromes [54,55,56,57,58,59,60,61,62,63,64,65,66,67]. However, there is not yet an ultimate scientific explanation; moreover, a clear understanding of the mechanisms elicited by SCS is still lacking [4,53,68].…”