Autonomic Nervous System and Spinal Cord Injury: Difference between revisions

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After a spinal cord injury, all three subsystems of the autonomic nervous system are affected due to their anatomical location, loss of supraspinal influence, and sustained responses to afferent stimuli.<ref name=":0">Henke AM, Billington ZJ, Gater DR Jr. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9320320/pdf/jpm-12-01110.pdf Autonomic Dysfunction and Management after Spinal Cord Injury: A Narrative Review.] J Pers Med. 2022 Jul 7;12(7):1110.</ref> The pathophysiological responses from the ANS that contribute to the comorbidities and mortality of SCI include the following systems:<ref name=":0" /><ref>Harding M. Autonomic Nervous System and Spinal Cord Injury. Plus Course 2024</ref>
After a spinal cord injury, all three subsystems of the autonomic nervous system are affected due to their anatomical location, loss of supraspinal influence, and sustained responses to afferent stimuli.<ref name=":0">Henke AM, Billington ZJ, Gater DR Jr. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9320320/pdf/jpm-12-01110.pdf Autonomic Dysfunction and Management after Spinal Cord Injury: A Narrative Review.] J Pers Med. 2022 Jul 7;12(7):1110.</ref> The pathophysiological responses from the ANS that contribute to the comorbidities and mortality of SCI include the following systems:<ref name=":0" /><ref>Harding M. Autonomic Nervous System and Spinal Cord Injury. Plus Course 2024</ref>


* Cardiovascular due to parasympathetic dominance with weakening influence of the sympathetic nervous system in cervical and high thoracic levels of spinal cord injury  
* Cardiovascular due to parasympathetic dominance with weakening influence of the sympathetic nervous system in cervical and high thoracic levels of spinal cord injury:
** Low resting arterial blood pressure
** Low resting arterial blood pressure
** Postural hypotension
** Postural hypotension
** Autonomic dysreflexia (Acute hypertension)
** Autonomic dysreflexia (Acute hypertension)
** Bradycardia or arrhythmia
** Bradycardia or arrhythmia
* Thermoregulatory
* Thermoregulatory as a result of sympathetic nervous system subsiding which inhibits sweating below the level of injury in high thoracic and cervical SCI. When body attempt to dissipate heat, excess sweating ; above the SCI, skin may be flushed, and excess sweating may occur as the body tries to dissipate heat
** Poikilothermia  
** Poikilothermia  
*** Absorbing an encompassing temperature as a result of inability to regulate core body temperature
*** Absorbing an encompassing temperature as a result of inability to regulate core body temperature

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Introduction[edit | edit source]

Anatomy of the Autonomic Nervous System (ANS)[edit | edit source]

There are two main functions of the autonomic nervous system:

  • regulating visceral functions
  • maintaining homeostasis within the human body

Sympathetic Nervous System (SNS)[edit | edit source]

Parasympathetic Nervous System (PNS)[edit | edit source]

Enteric Nervous System (ENS)[edit | edit source]

ANS and Spinal Cord Injury (SCI)[edit | edit source]

After a spinal cord injury, all three subsystems of the autonomic nervous system are affected due to their anatomical location, loss of supraspinal influence, and sustained responses to afferent stimuli.[1] The pathophysiological responses from the ANS that contribute to the comorbidities and mortality of SCI include the following systems:[1][2]

  • Cardiovascular due to parasympathetic dominance with weakening influence of the sympathetic nervous system in cervical and high thoracic levels of spinal cord injury:
    • Low resting arterial blood pressure
    • Postural hypotension
    • Autonomic dysreflexia (Acute hypertension)
    • Bradycardia or arrhythmia
  • Thermoregulatory as a result of sympathetic nervous system subsiding which inhibits sweating below the level of injury in high thoracic and cervical SCI. When body attempt to dissipate heat, excess sweating ; above the SCI, skin may be flushed, and excess sweating may occur as the body tries to dissipate heat
    • Poikilothermia
      • Absorbing an encompassing temperature as a result of inability to regulate core body temperature
    • Quad fever (idiopathic hyperpyrexia)
    • Exercise-induced fever
    • Hyperhidrosis or hypohidrosis
  • Respiratory
    • Bronchiolar constriction,
    • Hyper-reactive airways
    • Increased mucus secretion
  • Gastrointestinal
    • Acute and chronic increased in gastric acid secretions
    • High rates of biliary sludge, cholelithiasis and cholecystitis
    • Increased transit time at the distal colon
    • Reflex colorectal contractions
      • Constipation or bowel incontinence
  • Genitourinary
    • Bladder and bowel dysfunction
    • Sexual function affecting arousal, ejaculation, and orgasm
    • Problems during pregnancy, labour, and breastfeeding


And other procedures, such as functional electrical stimulation, surgery, invasive investigational procedures such as urodynamic studies. And then also during pain or injury: stretches, fractures, or UTIs.

Assessment of ANS in SCI[edit | edit source]

Function of the ANS in SCI[edit | edit source]

Resources[edit | edit source]

  • bulleted list
  • x

or

  1. numbered list
  2. x

References[edit | edit source]

  1. ↑ 1.0 1.1 Henke AM, Billington ZJ, Gater DR Jr. Autonomic Dysfunction and Management after Spinal Cord Injury: A Narrative Review. J Pers Med. 2022 Jul 7;12(7):1110.
  2. ↑ Harding M. Autonomic Nervous System and Spinal Cord Injury. Plus Course 2024
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