Cognitive performance in hypotensive persons with spinal cord injury.
BACKGROUND
Due to sympathetic de-centralization, individuals with spinal cord injury (SCI), especially those with tetraplegia, often present with hypotension, worsened with upright posture. Several investigations in the non-SCI population have noted a relationship between chronic hypotension and deficits in memory, attention and processing speed and delayed reaction times.


OBJECTIVE
To determine cognitive function in persons with SCI who were normotensive or hypotensive over a 24-h observation period while maintaining their routine activities.


METHODS
Subjects included 20 individuals with chronic SCI (2-39 years), 13 with tetraplegia (C4-8) and 7 with paraplegia (T2-11). Individuals with hypotension were defined as having a mean 24-h systolic blood pressure (SBP) below 110 mmHg for males and 100 mmHg for females, and having spent >or=50% of the total time below these gender-specific thresholds. The cognitive battery used included assessment of memory (CVLT), attention and processing speed (Digit Span, Stroop word and color and Oral Trails A), language (COWAT) and executive function (Oral Trails B and Stroop color-word).


RESULTS
Demographic parameters did not differ among the hypotensive and normotensive groups; the proportion of individuals with tetraplegia (82%) was higher in the hypotensive group. Memory was significantly impaired (P < 0.05) and there was a trend toward slowed attention and processing speed (P < 0.06) in the hypotensive compared to the normotensive group.


CONCLUSIONS
These preliminary data suggest that chronic hypotension in persons with SCI is associated with deficits in memory and possibly attention and processing speed, as previously reported in the non-SCI population.
VA Rehabilitation Research and Development Service, Center of Excellence for the Medical Consequences of Spinal Cord Injury, James J. Peters VA Medical Center, Rm. 1E-02 130 West Kingsbridge Rd., Bronx, NY, 10468, USA.
Adejoke B
AB
Jegede
Dwindally
D
Rosado-Rivera
William A
WA
Bauman
Christopher P
CP
Cardozo
Mary
M
Sano
Jeremy M
JM
Moyer
Monifa
M
Brooks
Jill Maria
JM
Wecht
D000203:Activities of Daily Living; D000328:Adult; D000375:Aging / Q000523:psychology; D001288:Attention / Q000502:physiology; D001794:Blood Pressure; D003071:Cognition / Q000502:physiology*; D003863:Depression / Q000523:psychology; D056344:Executive Function / Q000502:physiology; D006801:Humans; D007022:Hypotension / Q000209:etiology* / Q000523:psychology*; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D010264:Paraplegia / Q000523:psychology; D011597:Psychomotor Performance / Q000502:physiology*; D011782:Quadriplegia / Q000523:psychology; D011930:Reaction Time / Q000502:physiology; D013119:Spinal Cord Injuries / Q000150:complications* / Q000523:psychology*