Modulation of Blood Flow in the Skin of Human Legs during Transcutaneus Electrical Stimulation of the Spinal Cord
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lation of Blood Flow in the Skin of Human Legs during Transcutaneus Electrical Stimulation of the Spinal Cord G. I. Lobova, *, Yu. P. Gerasimenkoa, and T. R. Moshonkinaa aPavlov
Institute of Physiology Russian Academy of Sciences, St. Petersburg, Russia *e-mail: [email protected]
Received January 20, 2020; revised February 5, 2020; accepted March 20, 2020
Abstract—Changes in blood supply to the skin of the anterior-lateral surface of the shin of 12 healthy subjects were detected. The analysis was performed using laser Doppler flowmetry during transcutaneous electrical spinal cord stimulation (TSCS) by subthreshold bipolar pulses with a frequency of 30 Hz. The TSCS at T7 and L1 vertebrae level leads to a significant increase in cutaneous blood flow. With a stimulus intensity of 90% of the motor threshold, the increase in skin perfusion during stimulation at L1 was about 74%, and during stimulation at T7, 38%, relative to the baseline. We suggest that vasodilation and hyperemia of the skin during TSCS occur mainly due to the antidromic stimulation of sensory nerve fibers. Nitric oxide (NO) is an important modulator that promotes vasodilation in TSCS. It is released by the nerve endings and the layer of endothelial cells. Inhibition of cystathionine-γ-lyase significantly reduces the increase in skin blood flow during TSCS. Therefore, it was concluded that H2S, as well as NO, is also involved in the vasodilation in the skin during TSCS. Keywords: cutaneous blood flow, transcutaneous electrical stimulation of the spinal cord, microcirculation index, nitric oxide, hydrogen sulfide DOI: 10.1134/S0362119720040088
The spinal level of regulation of vascular tone is critical for regulating the metabolism of organs and tissues and for the functioning of the cardiovascular system (CVS) in general. The centers of the sympathetic nervous system are located in the thoracic and lumbar spinal cord, innervating the smooth muscle cells of blood vessels, as well as modulating the activity of neurons of the cervical nodes and affecting the work of the heart. A spinal cord injury in humans is accompanied by severe multiple dysfunctions of CVS functions: hypotension, hypothermia, dysregulation of coronary blood flow, orthostatic hypotension, and circulatory disorders in the skin [1]. Experimental studies of spinal mechanisms of regulation of peripheral blood circulation in humans, as a rule, are carried out exclusively in clinical conditions, with the participation of patients. Such studies involving healthy people were unavailable for ethical reasons until recently. The development of the method of transcutaneous electrical spinal cord stimulation (TSCS) of a person [2] removed this limitation, since the most important advantage of this method is the absolute non-invasiveness and, consequently, the absence of infectious and hardware complications [3]. It has been proven that TSCS selectively affects neural networks at different levels of the spinal cord [4].
Previously, we examined the mechanisms of regulation of peripheral blood flow
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