The catecholamine content of the peripheral plasma in human subjects with complete transverse lesions of the spinal cord

Munro, Alison F.; Robinson, R.

doi:10.1113/jphysiol.1960.sp006576

Cited by 35 publications

(12 citation statements)

References 14 publications

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“…In support of LF SBP ®ndings, subjects with paraplegia demonstrated comparable resting plasma norepinephrine levels to the control group with a signi®cant correlation between the two parameters (r=0.55, P50.01) (Figure 11). Similar observations in subjects with paraplegia for plasma norepinephrine values have been reported, 189 with the relatively low level (all below T-10) and incompleteness of injury, in part, explaining the absence of di erences between the two groups.…”

Section: Peripheral Vascular Functionsupporting

confidence: 86%

Risk factors for atherogenesis and cardiovascular autonomic function in persons with spinal cord injury

et al. 1999

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Persons with spinal cord injury (SCI) have been recognized to have several metabolic changes that adversely impact their risk for cardiovascular disease. An increased prevalence of disorders of carbohydrate metabolism and dyslipidemia may be related predominantly to paralysis with immobilization and associated loss of lean body tissue and gain in relative adiposity. Studies have reported an increased risk of vascular disease in those with SCI. As such, an understanding of the constellation of carbohydrate and lipid changes that occur after SCI is relevant to the clinical practice of medicine in this population. Oral glucose tolerance testing and associated studiesImpaired glucose tolerance and diabetes mellitus are more prevalent in individuals with SCI than in those who are able-bodied. 1 ± 4 In most of the individuals with SCI and abnormal carbohydrate tolerance, resistance to insulin mediation of glucose uptake by peripheral tissues may be demonstrable. In the presence of insulin resistance, the normal homeostatic response to glucose challenge is increased pancreatic b-cell secretion of insulin. If the compensatory response of the pancreas is insu cient to control the serum glucose concentration, worsening of carbohydrate tolerance will ensue.Bauman et al 3 performed a 75 g oral glucose tolerance test in 100 male veterans with SCI and in 50 able-bodied veteran controls. According to criteria established by the World Health Organization, 5 22% of those with SCI were diabetic whereas only 6% of the control group were diabetic. Eighty-two per cent of the controls had normal oral glucose tolerance, compared with 38% of those with quadriplegia and 50% of those with paraplegia. Subjects with SCI had signi®cantly higher mean plasma glucose and insulin values at several points during the oral glucose tolerance test when compared with controls ( Figure 1). In subgroups, determinants of insulin sensitivity were measured: per cent lean body mass, per cent fat mass, and cardiopulmonary ®tness. Values for insulin sensitivity were linearly related with those of ®tness (VO 2 max) determined from a progressive incremental upper-body exercise stress test. Insulin sensitivity was suggestively correlated with lean body mass, and negatively correlated with body fat. Thus, in a relatively small subgroup of untrained subjects with paraplegia, the strongest determinant of insulin sensitivity was cardiopulmonary ®tness.In 201 non-veteran subjects with SCI, Bauman et al 2 studied the relationship of oral carbohydrate tolerance after a 75 g glucose load to several variables, including level and completeness of lesion, gender, ethnicity, age, duration of injury, and anthropometric measures. Of the total group, 27 (13%) had diabetes mellitus and 56 (29%) had impaired glucose tolerance. 2,6 The subjects with complete tetraplegia had sign®cantly worse carbohydrate tolerance (Figure 2) and were more frequently classi®ed with a disorder of carbohydrate tolerance than the other neurological de®cit subgroups. 2 There were no signi®cant gend...

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Section: Peripheral Vascular Functionsupporting

confidence: 86%

Risk factors for atherogenesis and cardiovascular autonomic function in persons with spinal cord injury

et al. 1999

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“…Injury to the spinal cord above the first lumbar vertebrae results in reduced resting plasma norepinephrine, whereas injury below the third lumbar segment exhibits norepinephrine levels similar to able-bodied subjects [17]. Consequently, norepinephrine levels of the group with tetraplegia were significandy lower compared with all other groups.…”

Section: Discussionmentioning

confidence: 95%

The effects of autonomic dysfunction and endurance training on cardiovascular control

Wecht

et al. 2001

Clinical Autonomic Research

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The effects of autonomic dysfunction and regular activity on the cardiovascular system were investigated. The 48 participants included 12 subjects with tetraplegia, 12 subjects with paraplegia, 12 sedentary subjects, and 12 endurance-trained able-bodied controls. Central and peripheral autonomic data were obtained at rest to estimate efferent cardiac vagal output and sympathetic vasomotor control, and plasma norepinephrine concentration was determined as a marker of peripheral sympathetic activity. Cardiovascular parameters were obtained using a noninvasive cardiac output maneuver. The group with paraplegia did not differ from the sedentary group for efferent cardiac vagal output, but all other group comparisons were different (p <0.05). Sympathetic vasomotor control and stroke index were also similar between the paraplegia and sedentary groups, whereas both were increased in the endurance-trained group and were significantly reduced in the tetraplegia group. A strong relation between efferent cardiac vagal output and stroke index was established for the total group (r = 0.78, p <0.01), and analysis of covariance determined that the slope of this relation was similar among the groups. Sympathetic vasomotor control correlated significantly with plasma norepinephrine (r = 0.57, p <0.01), and a relation between sympathetic vasomotor control and stroke index was identified for the total group (r = 0.40, p <0.01). These results suggest that vagal control of resting central cardiac function is maintained despite autonomic dysfunction. The comparable findings in the paraplegia and sedentary groups suggest that regardless of peripheral autonomic dysfunction, the absence of regular physical activity has a similar effect on the resting vagal modulation and stroke index.

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“…This data is also supported by Wallin and Stjernberg (1984). Munro and Robinson (1960) found that individuals with complete quadriplegic injuries had low levels of serum epinephrine, achemical which augments the fight-flight response and which is normally released from the adrenal medulla by sympathetic activity.…”

mentioning

confidence: 52%

“…In complete quadriplegia, all neurologic communication between the brain and the body is broken at the level of injury (Corbett, Frankel & Harris, 1971a;Munro & Robinson, 1960) producing sympathectomization with interference in the normal functioning of the generalized fight-flight response. Corbett, Frankel, & Harris (1971b) found that complete quadriplegic individuals did not demonstrate arousal with either tactile stimulation above the level of injury or with cognitive stimulation.…”

mentioning

confidence: 99%

Autonomic Arousal and Fear in the Spinal Cord Injured

Winters¹,

Padilla²

1986

Rehabilitation Nursing

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A quasi‐experimental design was used to test the relationship between neurological status (cervical complete spinal cord injury versus lower thoracic‐lumbar spinal cord injury versus no injury — 15 subjects each group), physiological arousal, and self‐reports of fear in subjects exposed to a fear‐inducing film segment. Partial support was obtained for the hypothesis that neurological status is related to physiological arousal. Non‐injured subjects displayed the greatest arousal, with significant increases in pulse rate (p ◂ .001) and moderate increases in systolic (p = .06) and diastolic (p = .09) blood pressures during the film. Subjects with lower spinal cord injury showed equally significant increases in pulse rate (p ◂ .001), but only slight increases in diastolic blood pressure and no increases in systolic blood pressure. Those with complete cervical injury showed random fluctuations in all of the physiological measurements. No group showed any significant changes in respiratory rate. Moderate support for the expected relationship between neurological status and self‐reports of fear was found at a probability level of p = .07. The group with complete cervical injury reported less fear than the group with lower spinal cord injury or the non‐injured group.

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The catecholamine content of the peripheral plasma in human subjects with complete transverse lesions of the spinal cord

Cited by 35 publications

References 14 publications

Risk factors for atherogenesis and cardiovascular autonomic function in persons with spinal cord injury

Risk factors for atherogenesis and cardiovascular autonomic function in persons with spinal cord injury

The effects of autonomic dysfunction and endurance training on cardiovascular control

Autonomic Arousal and Fear in the Spinal Cord Injured

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