Supplemental Material for The Association Between Sleep and Cognitive Function in People With Spinal Cord Injury (SCI)

Individuals with high-level spinal cord injury (SCI) experience low blood pressure (BP) and cognitive impairments. Such dysfunction may be mediated in part by impaired neurovascular coupling (NVC) (i.e., cerebral blood flow responses to neurologic demand). Ten individuals with SCI > T6 spinal segment, and 10 age- and sex-matched controls were assessed for beat-by-beat BP, as well as middle and posterior cerebral artery blood flow velocity (MCAv, PCAv) in response to a NVC test. Tests were repeated in SCI after 10 mg midodrine (alpha1-agonist). Verbal fluency was measured before and after midodrine in SCI, and in the control group as an index of cognitive function. At rest, mean BP was lower in SCI (70 ± 10 versus 92 ± 14 mm Hg; P<0.05); however, PCAv conductance was higher (0.56 ± 0.13 versus 0.39 ± 0.15 cm/second/mm Hg; P<0.05). Controls exhibited a 20% increase in PCAv during cognition; however, the response in SCI was completely absent ( P<0.01). When BP was increased with midodrine, NVC was improved 70% in SCI, which was reflected by a 13% improved cognitive function ( P<0.05). Improvements in BP were related to improved cognitive function in those with SCI ( r2 = 0.52; P<0.05). Impaired NVC, secondary to low BP, may partially mediate reduced cognitive function in individuals with high-level SCI.

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Targeting inflammation to influence cognitive function following spinal cord injury: a randomized clinical trial

Spinal Cord ◽

10.1038/sc.2016.96 ◽

2016 ◽

Vol 55 (1) ◽

pp. 26-32 ◽

Cited By ~ 9

Author(s):

D J Allison ◽

A R Josse ◽

D A Gabriel ◽

P Klentrou ◽

D S Ditor

Keyword(s):

Clinical Trial ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Cognitive Function ◽

Randomized Clinical Trial ◽

Cord Injury

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A Motor Response Offset Score Mitigates Apparent Differences in Cognitive Function between People with and without Spinal Cord Injury

The FASEB Journal ◽

10.1096/fasebj.2019.33.1_supplement.738.17 ◽

2019 ◽

Vol 33 (S1) ◽

Author(s):

Jinhyun A Lee ◽

Shauna A Dudley‐Javoroski ◽

Patrick M McCue ◽

Kristin A Johnson ◽

Michael A Petrie ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cognitive Function ◽

Motor Response ◽

Cord Injury

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Cognitive function after spinal cord injury

Neurology ◽

10.1212/wnl.0000000000006244 ◽

2018 ◽

Vol 91 (13) ◽

pp. 611-621 ◽

Cited By ~ 25

Author(s):

Rahul Sachdeva ◽

Feng Gao ◽

Chetwyn C.H. Chan ◽

Andrei V. Krassioukov

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cognitive Impairment ◽

Brain Injury ◽

Sleep Apnea ◽

Cognitive Function ◽

Cardiovascular Control ◽

Current Evidence ◽

Control Group ◽

Cord Injury

ObjectiveTo systematically examine the incidence of cognitive impairment in individuals with spinal cord injury (SCI), as well as identify potential contributing and confounding factors.MethodsStudies quantitatively reporting cognitive ability after spinal cord injury were searched electronically via Medline, CINAHL, Embase, and PsycINFO. Manual screening for references within articles was also performed. A total of 2,481 studies were screened and a total of 70 were included in this review, 21 reporting cognitive function after SCI compared to an able-bodied control group and 49 with no able-bodied controls. Studies were analyzed for the incidence of impairment and the interactions with concomitant traumatic brain injury, psychological or somatic complaints, decentralized cardiovascular control, sleep apnea, neurologic level of injury, and age.ResultsThere is a high volume of evidence reporting substantial cognitive impairment in individuals with SCI. Potential co-contributors include concomitant brain injury, psychological or somatic comorbidities, decentralized cardiovascular control, and sleep apnea. Cognitive functioning was negatively correlated with age. No clear agreement was found for the incidence of cognitive impairment or its association with level of injury.ConclusionCurrent evidence suggests that individuals with SCI should be examined and addressed for cognitive impairment. Future studies aimed at identifying potential secondary causative factors should employ stringent controls for co-occurring brain trauma since it appears to be a major contributor and confounder to impaired cognition.

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Serum CCL21 as a Potential Biomarker for Cognitive Impairment in Spinal Cord Injury

BioMed Research International ◽

10.1155/2020/6692802 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Yuanzhen Chen ◽

Liangke Liang ◽

Shengnan Cao ◽

Guangjian Hou ◽

Qian Zhang ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Cognitive Impairment ◽

Cognitive Function ◽

Clinical Characteristics ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Potential Biomarker ◽

Cord Injury ◽

Moca Score

Objective. Cognitive impairment is considered to be an important complication of spinal cord injury (SCI), but its underlying mechanism remains unclear. The purpose of this study is to explore whether serum CCL21 can be used as a potential biomarker of cognitive impairment in SCI. Methods. In Neck-Shoulder and Lumbocrural Pain Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, hospitalized or treated acute SCI patients were included in the study as the SCI group (SCI). At the same time, a normal control group (NC) matching the age and sex of the SCI group was recruited in the outpatient clinic. Once the two groups were enrolled, their demographics and clinical characteristics were collected immediately. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum CCL21 levels within 24 hours of admission. Three months later, the Montreal Cognitive Assessment (MoCA) was used to test the cognitive function of the population. Results. A total of 84 SCI patients and 49 NC populations were eligible for inclusion in the study. There was no significant statistical difference in the demographics and clinical characteristics (age, gender, BMI, TG, LDL-C, FBG, SBP, and DBP) between the two groups ( p > 0.05 ). Compared with the NC group, the SCI group had a higher serum CCL21 level ( p < 0.001 ) and a lower MoCA score ( p < 0.001 ). Serum CCL21 level in SCI was negatively correlated with MoCA score ( p = 0.023 ). Multivariable analyses showed that serum CCL21 level is an independent prognostic factor of cognitive impairment in SCI. Conclusions. MoCA score has a linear relationship with serum CCL21 quartile, and SCI cognitive function has a negative correlation with serum CCL21. Serum CCL21 is an independent risk factor for cognitive impairment after SCI.

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