Cerebrovascular function is preserved during mild hyperthermia in cervical spinal cord injury

Abstract

Study design

Experimental study.

Objectives

Compromised cerebrovascular function likely contributes to elevated neurological risk in spinal cord injury (SCI). Passive heating offers many cardiovascular and neurological health benefits; therefore, we aimed to determine the effects of an acute bout of heating on cerebrovascular function in chronic SCI.

Methods

Persons with cervical SCI (n = 15) and uninjured controls (CON; n = 15) completed 60 min of lower limb hot water immersion (40 °C). Assessments of middle cerebral (MCA) and posterior cerebral artery (PCA) velocities, pulsatilities, and neurovascular coupling (NVC) were performed using transcranial Doppler ultrasound. Duplex ultrasonography was used to index cerebral blood flow via the internal carotid artery (ICA), and carotid-femoral pulse-wave velocity (PWV) was measured using tonometry. The NVC response was quantified as the peak hyperemic value during 30-s cycles of visual stimulation.

Results

Mean arterial pressure changed differentially with heating [mean (standard deviation); SCI: +6(14) mmHg, CON: −8(12) mmHg; P = 0.01]. There were no differences in any intracranial artery measures (all P > 0.05), except for small (~10%) increases in MCA conductance in CON after heating vs. SCI (interaction P = 0.006). Resting ICA flow was greater in SCI vs. CON (P = 0.03) but did not change with heating in either group (interaction P = 0.34). There were also no between-group differences in the NVC response (ΔPCA conductance) pre- [SCI: 29(19)% vs. CON: 30(9)%] or post-heating [SCI 30(9)% vs. 25(9)%; interaction P = 0.22].

Conclusions

Mild acute heating does not impair or improve cerebrovascular function in SCI or CON. Thus, further study of the effects of chronic heating interventions are warranted.

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Fig. 1

Data archiving

The individual datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank the participants for volunteering their time for this study.

Funding

This study was supported in part by a Seed Grant from ICORD supported by the Blusson Integrated Cures Partnership (PNA), Canada Research Chairs program (PNA), and University of Calgary Start-up funds (AAP).

Author information

GBC and PNA. conceived and designed the study, collected data, interpreted results, and drafted the manuscript. OB, AAP, TM, ZKS, AHXL, JWS, AVK, and ZD collected data and interpreted results. HGC analysed and interpreted data. All authors critically revised the manuscript and approved the final version. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All persons designated as authors qualify for authorship, and all those who qualify for authorship are listed.

Correspondence to Geoff B. Coombs.

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Coombs, G.B., Vucina, D., Caldwell, H.G. et al. Cerebrovascular function is preserved during mild hyperthermia in cervical spinal cord injury. Spinal Cord 57, 979–984 (2019). https://doi.org/10.1038/s41393-019-0321-1

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