Autonomic dysreflexia (AD) is a potentially life-threatening temporary episode of severe high blood pressure, which can occur daily in individuals with spinal cord injury (SCI). Chronic high blood pressure in non-SCI individuals results in changes in blood supply to the brain associated with increased risk of stroke, changes in the structural pattern of the brain, as well as loss of intellectual functioning. We do not currently understand if temporary high blood pressure in the form of AD episodes after SCI is having similar effects as chronic high blood pressure. Therefore, this trial aims to study the effect of AD on brain blood vessel function and cognition.
Participation in this study consists of two visits:
- The first visit (3 hours) at ICORD in the Blusson Spinal Cord Centre, for a number of non-invasive assessments of blood pressure and brain blood flow, questionnaires and cognitive tests.
- The second visit (1.5 hours) at UBC MRI Research Centre for an MRI scan, where you will be asked to lie still for 1-15 minute intervals over a total period of roughly 33 minutes.
Why should you participate in this study?
Cardiovascular, and particularly cerebrovascular complications such as stroke are the leading cause of death among those with SCI. This study hopes to understand the influence of AD on cerebral blood vessels and the extent to which this effects cognition. We hope that the information learned from this study can be used in the future to benefit individuals with SCI. While the MRI scan is being performed for research purposes, if the radiologist detects an abnormality which requires follow-up we will contact you immediately.
You may be eligible to participate in this study if
- you had a traumatic motor-complete SCI with at least 12 months post injury
- your level of injury between C4-T6
- you are AIS (ASIA Impairment Scale) A or B
- you are 19-65 years old
- you currently experience episodes of AD on a daily basis.
- you have a good command and comprehension of English
- you pass screening by an MRI technologist in order to participate in second visit
You may not be able to participate if you
- have a documented traumatic brain injury at any point in your life. – If you have a previous history of severe cognitive impairment
- have a history of cardiovascular disease, diabetes, obesity, or untreated depression.
You will not be able to participate in the MRI portion of the study:
- If you are pregnant, or if you plan to start a pregnancy soon. Although the strong magnetic field used for a magnetic resonance image (MRI) test does not appear to be harmful, an MRI is not usually done during pregnancy.
- If you have a non-MRI safe intrauterine device (IUD) in place
- If you weigh more than 158 kg (350 lbs)
- If you have claustrophobia (fear of small, confined spaces)
- If you have metallic foreign bodies in the eye, cardiac pacemakers, clips in the central nervous system, automatic internal cardiac defibrillators, implanted infusion pumps, implanted insulin pumps, bone growth stimulators, non-removable neurological stimulators, cochlear implants, or shrapnel
- Excessive movements can affect the accuracy of the MRI scan. You may not be a suitable candidate if you are unable to remain still during the MRI scan
- Head circumference >63.5 cm or distance from back of head to tip of nose >24 cm while lying in a supine position (this is the maximum possible size of a participants head to fit into the MR Head coil).
Visit 1 = 3 hours. Visit 2 = 1.5 hours. Total = 4.5 hours (not including travel)
Compensation for participation: At the end of the study, you will receive $25 per visit of honorarium to cover your travel expenses.
The study will take place at ICORD and UBC
For more information or to sign up to participate in this study, please contact the study coordinator, Dr. Tom Nightingale, by email or call 778-798-2710
This study is funded by a grant from the Heart and Stroke Foundation of Canada. The equipment used for this study at ICORD was funded by the Canada Foundation for Innovation and the BC Knowledge Development Fund.