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Modified cold pressor test by cold application to the foot after spinal cord injury: suggestion of hemodynamic control by the spinal cord.

AbstractOBJECTIVE:
Study hemodynamic responses to cold application to the foot (CAF) to explore the autonomic cardiovascular control by the spinal cord.
DESIGN:
Controlled experimental study. Hemodynamic variables were measured or calculated for 13 healthy subjects, 10 patients with traumatic T4-T6 paraplegia, and 11 patients with traumatic C4-C7 tetraplegia. Subjects were continuously monitored for heart rate (HR), blood pressure (BP), and cerebral blood-flow velocity (CBFV) from 5 mins before to 5 mins after 40-120 secs of CAF by ice water foot immersion. The recorded signals were digitized online and analyzed offline in the time and frequency domains.
RESULTS:
During CAF, HR increased in the control group but decreased in patients (P < 0.001). BP increased significantly in the control and tetraplegia groups (P < 0.001) and nonsignificantly in the paraplegia group. HR and BP spectral components (LF, HF, LF/HF) did not change significantly. CBFV increased significantly in the patient groups (P < 0.05) but not in the control subjects. The cerebrovascular resistance increased significantly in the control and tetraplegia groups (P < 0.001), but not in the paraplegia group.
CONCLUSIONS:
The findings support the presence of hemodynamic autonomic control by the spinal cord and show that responses to CAF can be used to assess its integrity.
AuthorsA Catz, V Bluvshtein, A D Korczyn, I Pinhas, I Gelernter, T Nissel, Y Vered, N M Bornstein, S Akselrod
JournalAmerican journal of physical medicine & rehabilitation (Am J Phys Med Rehabil) Vol. 86 Issue 11 Pg. 875-82 (Nov 2007) ISSN: 0894-9115 [Print] United States
PMID18049135 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Adult
  • Autonomic Dysreflexia (physiopathology)
  • Cerebrovascular Circulation (physiology)
  • Cold Temperature
  • Female
  • Foot
  • Hemodynamics
  • Humans
  • Paraplegia (rehabilitation)
  • Quadriplegia (rehabilitation)
  • Spinal Cord (physiology)
  • Spinal Cord Injuries (physiopathology)

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