200 Section - Real-time transcutaneous spinal cord stimulation mitigates autonomic dysreflexia and vascular shear rate during genital stimulation in chronic spinal cord injury

Wednesday, May 20, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

MS

Mohamed Gomaa Sobeeh, PhD

Postdoctoral 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
SS

Soshi Samejima, PhD

assistant professor
University of Washington
Seattle, Washington, United States
CC

Christopher Chang, BS

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

Stephanie Quon, BS

work learn student
University of British Columbia
vacouver, 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
AK

Armin Khavandegar, MD

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

Xue Zhu, MD

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

Shane Balthazaar, PhD

Postdoctoral Fellow
University of Birmingham
Birmingham, England, United Kingdom
CS

Claire Shackleton, PhD

Postdoctoral Fellow
University of Texas Health Science Center Houston
Houston, Texas, United States
Stacy Elliott, MD (she/her/hers)

Clinical Professor
University of British Columbia
Vancouver, British Columbia, Canada
RS

Rahul Sachdeva, PhD

Assistant Professor
University of Kentucky
Lexington, Kentucky, United States
AK

Andrei Krassioukov, MD

Professor
ICORD
Vancouver, British Columbia, Canada

Objectives :

Cardiovascular and sexual dysfunctions are common after spinal cord injury (SCI), contributing to higher mortality rates and reduced quality of life. Genital stimulation frequently triggers autonomic dysreflexia (AD)—a sudden surge in blood pressure (BP) that compromises vascular health, increases stroke rates, and impairs sexual activity and satisfaction. Transcutaneous spinal cord stimulation (tSCS) shows promise for restoring cardiovascular and sexual functions. This study investigated the real-time effects of tSCS on AD severity and common carotid artery shear rates during genital stimulation.

Design:

Ten individuals (8 males, 2 females) with chronic motor-complete SCI above T6 underwent 30-second genital vibrostimulation (GVS; penile or clitoral) with and without tSCS, while continuous beat-by-beat BP and common carotid artery shear rate were recorded. AD severity and shear rates were quantified as the change in systolic BP (ΔSBP) and shear rates from the one-minute pre-GVS average to the peak during GVS. Each participant completed four GVS trials: two without tSCS and two with tSCS applied at either mid-thoracic (T7–T8 and T9–T10) or lumbosacral (T11–T12 and L1–L2) vertebral levels (30 Hz, monophasic waveform, 1-ms pulse width).

Results:

Baseline GVS induced severe AD (ΔSBP = 53.4 ± 25.9 mmHg), with higher shear rates (128.2 ± 28.5 S^-1). Both real-time lumbosacral and mid-thoracic tSCS significantly reduced AD severity (ΔSBP = 34.3 ± 20.5 mmHg and 35.4 ± 25.3 mmHg, respectively; p < 0.05) and shear rates (68.2 ± 75.2 S^-1and 83.4 ± 49.5 S^-1, respectively, p < 0.05).

Conclusion:

Real-time lumbosacral or mid-thoracic tSCS can attenuate AD severity and common carotid artery shear rates during genital stimulation, with lumbosacral tSCS showing the greatest improvement. These findings suggest the potential of tSCS to reduce cardiovascular consequences from pelvic stimulation and enhance sexual activity engagement after SCI.