Bionic epidural stimulation restores arterial pressure regulation during orthostasis

Yusuke Yanagiya, Takayuki Sato, Toru Kawada, Masashi Inagaki, Teiji Tatewaki, Can Zheng, Atsunori Kamiya, Hiroshi Takaki, Masaru Sugimachi, Kenji Sunagawa

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

A bionic baroreflex system (BBS) is a computer-assisted intelligent feedback system to control arterial pressure (AP) for the treatment of baroreflex failure. To apply this system clinically, an appropriate efferent neural (sympathetic vasomotor) interface has to be explored. We examined whether the spinal cord is a candidate site for such interface. In six anesthetized and baroreflex-deafferentiated cats, a multielectrode catheter was inserted into the epidural space to deliver epidural spinal cord stimulation (ESCS). Stepwise changes in ESCS rate revealed a linear correlation between ESCS rate and AP for ESCS rates of 2 pulses/s and above (r2, 0.876-0.979; slope, 14.3 ± 5.8 mmHg·pulses-1·s; pressure axis intercept, 35.7 ± 25.9 mmHg). Random changes in ESCS rate with a white noise sequence revealed dynamic transfer function of peripheral effectors. The transfer function resembled a second-order, low-pass filter with a lag time (gain, 16.7 ± 8.3 mmHg·pulses-1·s; natural frequency, 0.022 ± 0.007 Hz; damping coefficient, 2.40 ± 1.07; lag time, 1.06 ± 0.41 s). On the basis of the transfer function, we designed an artificial vasomotor center to attenuate hypotension. We evaluated the performance of the BBS against hypotension induced by 60° head-up tilt. In the cats with baroreflex failure, head-up tilt dropped AP by 37 ± 5 mmHg in 5 s and 59 ± 11 mmHg in 30 s. BBS with optimized feedback parameters attenuated hypotension to 21 ± 2 mmHg in 5 s (P < 0.05) and 8 ± 4 mmHg in 30 s (P < 0.05). These results indicate that ESCS-mediated BBS prevents orthostatic hypotension. Because epidural stimulation is a clinically feasible procedure, this BBS can be applied clinically to combat hypotension associated with various pathophysiologies.

Original languageEnglish
Pages (from-to)984-990
Number of pages7
JournalJournal of Applied Physiology
Volume97
Issue number3
DOIs
Publication statusPublished - Sep 1 2004
Externally publishedYes

Fingerprint

Bionics
Baroreflex
Dizziness
Spinal Cord Stimulation
Arterial Pressure
Hypotension
Cats
Head
Controlled Hypotension
Epidural Space
Orthostatic Hypotension
Treatment Failure
Spinal Cord
Catheters
Heart Rate
Pressure

Keywords

  • Autonomic nervous system
  • Baroreceptors
  • Blood pressure
  • Orthostatic hypotension
  • Shy-Drager syndrome

ASJC Scopus subject areas

  • Physiology
  • Endocrinology
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Yanagiya, Y., Sato, T., Kawada, T., Inagaki, M., Tatewaki, T., Zheng, C., ... Sunagawa, K. (2004). Bionic epidural stimulation restores arterial pressure regulation during orthostasis. Journal of Applied Physiology, 97(3), 984-990. https://doi.org/10.1152/japplphysiol.00162.2004

Bionic epidural stimulation restores arterial pressure regulation during orthostasis. / Yanagiya, Yusuke; Sato, Takayuki; Kawada, Toru; Inagaki, Masashi; Tatewaki, Teiji; Zheng, Can; Kamiya, Atsunori; Takaki, Hiroshi; Sugimachi, Masaru; Sunagawa, Kenji.

In: Journal of Applied Physiology, Vol. 97, No. 3, 01.09.2004, p. 984-990.

Research output: Contribution to journalArticle

Yanagiya, Y, Sato, T, Kawada, T, Inagaki, M, Tatewaki, T, Zheng, C, Kamiya, A, Takaki, H, Sugimachi, M & Sunagawa, K 2004, 'Bionic epidural stimulation restores arterial pressure regulation during orthostasis', Journal of Applied Physiology, vol. 97, no. 3, pp. 984-990. https://doi.org/10.1152/japplphysiol.00162.2004
Yanagiya, Yusuke ; Sato, Takayuki ; Kawada, Toru ; Inagaki, Masashi ; Tatewaki, Teiji ; Zheng, Can ; Kamiya, Atsunori ; Takaki, Hiroshi ; Sugimachi, Masaru ; Sunagawa, Kenji. / Bionic epidural stimulation restores arterial pressure regulation during orthostasis. In: Journal of Applied Physiology. 2004 ; Vol. 97, No. 3. pp. 984-990.
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