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Peri-spinal Neurovascular Response Triggered by a Painless Electrical Nerve Stimulation in Patients with Chronic Arterial Hypertension

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Abstract

Purpose

Alterations of the central nervous system are frequent complications in patients with chronic arterial hypertension (AHT). However, functional spinal cord lesions are not often detected in these patients despite diagnostic advances in neuroimaging and electrophysiology. Recently, a new non-invasive functional near infrared spectroscopy (fNIRS) application was developed for assessment of the peri-spinal neurovascular response (NVR) as a functional test of the spinal cord.

Methods

The continuous wave fNIRS technique was applied to detect changes in O2Hb concentration during the peri-spinal NVR triggered by non-noxious electrical stimulation of the median nerve at the wrist, and recorded at cervical and thoracic spinal levels using three different stimulation protocols in subjects with AHT treated with losartan (n = 22; 142.14 ± 133.9 months of disease) and compared to healthy control subjects (n = 37). The body mass index (BMI) and the median nerve conduction velocity (NCV) were also recorded.

Results

The NVR of patients with AHT showed a significantly lower amplitude (− 70.4%; cervical), longer rise time (+ 22.2%; cervical), and longer duration (+ 28.0%; thoracic) than the control group (p < 0.01). The stimulus intensity-response in the AHT group was − 53.5%, − 55.9%, and − 63% lower in amplitude than the controls (p < 0.05) for the increasing stimulus intensity steps (5; 7.5 and 10 mA, respectively) at the cervical level. Patients with BMI > 30 showed more intense changes. The median NCV was normal for both groups.

Conclusion

These data show, for the first time, the difference in peri-spinal NVR between normal subjects and losartan-treated ATH patients, indicating the potential of a non-invasive fNIRS technique to find sensory functional abnormalities of the spinal cord in these patients.

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Data availability

The data are available from the corresponding author upon reasonable request.

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Funding

This study was funded by FONDEF grant Number ID21I10092, Fondecyt Postdoc 2021 N321030 and Fundación COPEC-UC grant Number 2018R.1030.

Author information

Authors and Affiliations

  1. Center of Biomedical Imaging, Radiology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    Juan Pablo González Appelgren, Raúl Caulier-Cisterna, Juan Esteban Oyarzún & Sergio Uribe

  2. Rielo Institute for Integral Development, New York, USA

    Raúl Caulier-Cisterna

  3. Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Chancellors Walk, Clayton Campus, Victoria, Australia

    Sergio Uribe

  4. Translational Neuroscience Laboratory, Faculty of Medicine, Universidad Diego Portales, 233 Ejercito Libertador, Santiago, Chile

    Antonio Eblen-Zajjur

Authors
  1. Juan Pablo González Appelgren
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  2. Raúl Caulier-Cisterna
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  3. Juan Esteban Oyarzún
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  4. Sergio Uribe
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  5. Antonio Eblen-Zajjur
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Contributions

SU and AEZ participated in the design of this study. JPGA, RCC, JEO, and AEZ carried out the study, JPGA, RCC, and AEZ performed the statistical analysis and drafted the manuscript. SU and AEZ reviewed the manuscript. All authors contributed to manuscript revision and read and approved the submitted version.

Corresponding author

Correspondence to Antonio Eblen-Zajjur.

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Conflict of interest

Two investigators from the present article were participants in the patent process of one of the devices used in the present method. Patent: F.I. Valenzuela, S.A. Uribe, A. Eblen-Zajjur, R. Sitaram, M. Rana. Device for recording the vascular response of the human spinal cord triggered by a suprasensible stimulus through the use of functional near-infrared spectroscopy. U.S. Patent Application 16/958,433, Feb. 25, 2021.

Ethical Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Pontificia Universidad Católica de Chile (PUC-170914003, 2017).

Consent to Participate

Informed and written consent was obtained from all individual participants included in the study.

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Appelgren, J.P.G., Caulier-Cisterna, R., Oyarzún, J.E. et al. Peri-spinal Neurovascular Response Triggered by a Painless Electrical Nerve Stimulation in Patients with Chronic Arterial Hypertension. J. Med. Biol. Eng. 43, 303–311 (2023). https://doi.org/10.1007/s40846-023-00789-w

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  • DOI: https://doi.org/10.1007/s40846-023-00789-w

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