Autonomic Nervous System and Spinal Cord Injury

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Anatomy of the Autonomic Nervous System (ANS)

There are two main functions of the autonomic nervous system:

• regulating visceral functions
• maintaining homeostasis within the human body

ANS and Spinal Cord Injury (SCI)

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. The pathophysiological responses from the ANS that contribute to the comorbidities and mortality of SCI include the following systems:

• 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.

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