title: Cold pressor test in tetraplegia and paraplegia suggests an independent role of the thoracic spinal cord in the hemodynamic responses to cold.
abstract: BACKGROUND
  Cold application to the hand (CAH) is associated in healthy people with increase in heart rate (HR) and blood pressure (BP).
  
  
  OBJECTIVE
  To study hemodynamic responses to CAH in humans following spinal cord injuries of various levels, and examine the effect of spinal cord integrity on the cold pressor response.
  
  
  METHODS
  An experimental controlled study.
  
  
  METHODS
  The spinal research laboratory, Loewenstein Hospital, Raanana, Israel.
  
  
  METHODS
  Thirteen healthy subjects, 10 patients with traumatic T(4-6) paraplegia and 11 patients with traumatic C(4-7) tetraplegia.
  
  
  METHODS
  HR, BP, HR and BP spectral components (low frequency, LF; high frequency, HF; LF/HF), cerebral blood flow velocity (CBFV) and cerebrovascular resistance index (CVRi).
  
  
  METHODS
  The outcome measures of the three subject groups monitored for HR, BP and CBFV were compared from 5 min before to 5 min after 40-150 s of CAH. The recorded signals were digitized online and analyzed offline in both the time and frequency domains.
  
  
  RESULTS
  During CAH, HR and CVRi increased significantly in all subject groups (P<0.001), and BP in control subjects and in the tetraplegia group (P<0.01). BP increase was not statistically significant in paraplegia, and CBFV, HR LF, HR HF and BP LF did not change significantly during CAH in any group.
  
  
  CONCLUSIONS
  The CAH effect in tetraplegia and the suppressed BP increase in paraplegia, supported by the other findings, suggest a contribution of an independent thoracic spinal mechanism to the cold pressor response.
authors.affiliation: The Spinal Department, Loewenstein Rehabilitation Hospital, Raanana, Israel. amcatz@post.tau.ac.il
authors.forename: A
authors.initials: A
authors.lastname: Catz
authors.forename: V
authors.initials: V
authors.lastname: Bluvshtein
authors.forename: I
authors.initials: I
authors.lastname: Pinhas
authors.forename: S
authors.initials: S
authors.lastname: Akselrod
authors.forename: I
authors.initials: I
authors.lastname: Gelernter
authors.forename: T
authors.initials: T
authors.lastname: Nissel
authors.forename: Y
authors.initials: Y
authors.lastname: Vered
authors.forename: N
authors.initials: N
authors.lastname: Bornstein
authors.forename: A D
authors.initials: AD
authors.lastname: Korczyn
mesh_terms: D000328:Adult; D001158:Arteries / Q000294:innervation / Q000503:physiopathology; D020211:Autonomic Dysreflexia / Q000503:physiopathology*; D001341:Autonomic Nervous System / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D001833:Body Temperature Regulation / Q000502:physiology; D003080:Cold Temperature / Q000009:adverse effects; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000150:complications / Q000503:physiopathology*; D011782:Quadriplegia / Q000150:complications / Q000503:physiopathology*; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D013116:Spinal Cord / Q000503:physiopathology*; D013904:Thoracic Vertebrae; D014661:Vasoconstriction / Q000502:physiology