300 Section - Transcutaneous Spinal Cord Stimulation Mitigates Orthostatic Hypotension and Enhances Cognitive Performance in Motor-Complete Spinal Cord Injury

Wednesday, May 20, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

AK

Armin Khavandegar, MD

Postdoctoral Research Fellow
University of British Columbia
VANCOUVER, British Columbia, Canada

Co-Author/Coautor(s)

RM

Raza Malik, PhD

Postdoctoral Fellow
University Of British Columbia
Vancouver, British Columbia, Canada
MS

Mohamed Gomaa Sobeeh, PhD

Postdoctoral Fellow
University Of British Columbia
Vancouver, British Columbia, Canada
CC

Christopher Chang, BS

research coordinator
University Of British Columbia
vancouver, British Columbia, Canada
GM

Graeme McIntosh, BS

research coordinator
University of British Columbia
Vancouver, British Columbia, Canada
TS

Tina Saffar, BS

research coordinator
University of British Columbia
Vancouver, British Columbia, Canada
XZ

Xue Zhu, MD

Postdoctoral Fellow
University of British Columbia
Vancouver, British Columbia, Canada
RS

Rahul Sachdeva, PhD

Assistant Professor
University of Kentucky
Lexington, Kentucky, United States

Corresponding Author/Autor a quien dirigir la corr(s)

AK

Andrei Krassioukov, MD

Professor
ICORD
Vancouver, British Columbia, Canada

Objectives : Individuals with spinal cord injury (SCI) above the T6 level frequently experience orthostatic hypotension (OH). Transcutaneous spinal cord stimulation (tSCS) has emerged as a promising noninvasive intervention to modulate autonomic function; however, its effects on blood pressure (BP) regulation and cognition in OH remain underexplored.

Design: Participants with chronic motor-complete cervical SCI underwent a 60° Head-Up Tilt Test (HUTT) with and without tSCS. OH severity was assessed as changes in systolic BP (SBP) and diastolic BP (DBP) from the one-minute pre-tilt average compared to the three-minute post-tilt value. Each participant completed three HUTTs: one without tSCS and two with stimulation applied at either mid-thoracic (MT; T7–T8/T9–T10) or lumbosacral (LS; T11–T12/L1–L2) levels. Cognitive performance was assessed using the Stroop Test (Color, Word, and Color-Word components).

Results: Five male participants with OH (mean age 40.2±13.4 years; four C4 and one C5; time since injury 12±14.7years) were included. During tilt without stimulation, SBP and DBP decreased by 34.4±28.1mmHg and 13.9±15.2, respectively, relative to baseline. With MT stimulation, SBP decreased by 8.5±34.2 and DBP increased by 4.4±18.1. With LS stimulation, SBP decreased by 8.1±25.2 and DBP increased by 3.5±20.3. LS and MT stimulation both significantly mitigated OH compared with no stimulation, evidenced by smaller decreases in SBP (P=0.041 and 0.037, respectively). There was no significant difference between the two stimulation modes (P >0.05). During the Stroop test, average completion time increased by 5.0±9.1s during tilt without stimulation and by 6.4±17.5s during MT stimulation, while it decreased by 1.3±30.0s during LS stimulation (P >0.05).

Conclusion: TSCS at both MT and LS levels mitigated BP decline during HUTT in individuals with SCI and OH. While cognitive findings suggested possible differences between stimulation locations, these trends were not statistically significant. Determining whether the stimulation site meaningfully influences cognitive outcomes will require further investigation in larger cohorts.