Rahul Sachdeva and Andrei Krassioukov, ICORD, University of British Columbia, Vancouver, Canada

Transcutaneous spinal cord stimulation for autonomic recovery

Funded in: 2021, 2022, 2023


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Problem: Devastating dysfunctions in blood pressure, bowel and bladder control
Target: Test the potential of non-invasive spinal cord stimulation
Goal: Enable wider clinical use of spinal cord stimulation

Spinal cord injury (SCI) results in devastating dysfunctions in blood pressure (BP), bowel and bladder control. These dysfunctions invade into all aspects of life post-SCI and dictate the overall health and survival. These invisible complications have remained relatively under-investigated, despite being among the top patient priorities for functional recovery.

BP dysfunction after SCI presents as an extreme yo-yo effect, with BP fluctuating between too low to dangerously high within the same individual, several times a day.  Furthermore, storage and voiding dysfunctions in bowel and bladder also present a daily challenge, negatively impacting the quality of life. For example, the time needed for bowel care in individuals with SCI can be over two hours. While dysfunctions in these individual systems are debilitating by themselves, the shared spinal circuitry across these systems further amplifies the problem. For example, routine stimuli arising from bowel or bladder are the most frequent triggers of rapid, life-threatening BP surges in individuals with SCI.

Currently available solutions to this problem mainly target the management of symptoms and do not result in meaningful functional recovery. Electrical stimulation of the spinal cord via surgically implanted electrodes has been shown to recover autonomic function after SCI. However, the surgical implantation of electrodes and spinal cord stimulator is invasive, expensive and has inherently associated risks. Moreover, the inability to re-position the implanted stimulator considerably limits the flexibility of this procedure.

The aim of this project is to test the potential of non-invasive spinal cord stimulation (via electrodes applied over skin) to promote recovery of BP, bowel and bladder function in a clinically relevant rat model of SCI. This project will allow to understand the underlying mechanisms and enable wider clinical use of spinal cord stimulation in improving quality of life of individuals with SCI.