Cardiovascular-autonomic Research

Investigator: Jill M. Wecht, Ed.D

 

After suffering a SCI, maintaining blood pressure is often a challenge. We are studying how SCI disrupts normal blood pressure regulation. The benefit of medications to keep blood pressure in the normal range while sitting is being evaluated. We believe that keeping blood pressure normal while seated upright should help maintain brain blood flow and improve thinking in persons with SCI.


Measurement of autonomic cardiovascular integrity in persons with SCI
You will receive in random order on 4 different study visits, placebo, edrophodium (vagal agonist), glycopyrrolate (vagal antagonist), or glycopyrrolate+esmolol (beta-1 agonist). On these test days, you will be doing several easy to perform non-invasive tests on a laboratory bed. During the drug infusion, an iced cold bag will be applied on your forehead for one minute. After the drug administration, a head up tilt will be performed lifting your bed up to a 70° angle. Blood pressure and heart rate responses will be measured throughout these procedures.

Entry Criteria: SCI for >12months; no history of cardiovascular disease; not currently taking medication to treat blood pressure problems; no current illness or infection
Time Commitment: 2 hours/visit; 4 total visits
Reimbursement: $100/day


Blood Pressure, Cerebral Blood Flow, and Cognition in persons with SCI: Observational Study
You will be given a blood pressure monitor in which you will be asked to record three blood pressure readings every day for a total of 30 days. You will also be provided with a journal to record all blood pressure readings as well as daily activities that you participate in each day. There will also be a short survey on autonomic dysreflexia that you must complete every week.

Entry Criteria: SCI for >12months, between ages 18-75, wheelchair dependent, no current illness or infection, no major surgery within the past 30 days
Time Commitment: 30 days
Reimbursement: $25/week


Blood Pressure, Cerebral Blood Flow, and Cognition in persons with SCI: ACUTE Study
You will receive in random order on 2 different study visits, placebo or midodrine. You will be asked to do several thinking tasks while having your heart rate, blood pressure, respiration, and cerebral blood flow monitored. You will then take a small pill of one of the randomized drug. After 40 minutes, you will be asked to do a second battery of thinking tasks.

Entry Criteria: SCI for >12 months; between ages 18-75; wheelchair dependent; low pressure: males- systolic blood pressure <110 mmHg and/or diastolic blood pressure <70 mmHg, females - systolic blood pressure <100 mmHg and/or diastolic blood pressure <70 mmHg
Time Commitment: 2.5-3.0 hours/ visit; 2 total visits
Reimbursement: $100/visit


Blood Pressure, Cerebral Blood Flow, and Cognition in persons with SCI: 30-day Study
You will be asked to participate in a 10-week study where for 30 days (4 weeks) you will be asked to take a supply of medication, followed by a14 days (2 weeks) washout period, and another 30 days (4 weeks) of treatment. During the 10-week study, you will be asked to visit the laboratory 6 times where your heart rate, blood pressure, breathing rate, and blood flow to your brain will be monitored and complete a survey on autonomic dysreflexia (AD). For 2 of the laboratory visits, you will be asked to complete several thinking tasks and a quality of life survey.

Entry Criteria: SCI for >12 months; between ages 18-75; wheelchair dependent; low pressure: males- systolic blood pressure <110 mmHg and/or diastolic blood pressure <70 mmHg, females - systolic blood pressure <100 mmHg and/or diastolic blood pressure <70 mmHg; have completed the acute study and the 30-day observational study
Time Commitment: Visit 1: 4 hours; Visit 2: 2 hours; Visit 3: 4 hours; Visit 4: 4 hours; Visit 5: 2 hours; Visit 6: 4 hours
Reimbursement: $100/visit for visits 1, 3, 4, and 6; $50/visit for visits 2 and 5


Cardiovascular, Cerebrovascular, and Cognitive Function in SCI
You will first be screened to determine whether you will be eligible for the main study through an eye exam, a mini mental test, traumatic brain injury screening questionnaires and whether you have any health conditions that may exclude participation in the study. When you are determined eligible for the main study, you will then complete several thinking tasks while having your heart rate, blood pressure, respiration, and cerebral blood flow monitored. After the thinking tasks, a pen-like probe will be used to measure arterial stiffness on the surface of your neck, leg, and arm.

Entry Criteria: SCI for >12 months; between the ages of 30-85; fluent in English; visual acuity 20/60 in worst eye (with prescription eyewear); no current illness of infection; no history of neurological disease; no history of schizophrenia or bipolar disorder or any active psychosis
Time Commitment: Screening visit: 30 minutes; Testing visit: 3 hours
Reimbursement: $60/visit

Studies Underway

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Contact Us

Nhuquynh (NuNu) Nguyen, Research Coordinator
(718) 584-9000 ext 1732
nhuquynh.nguyen@va.gov

Kel Morin, Research Coordinator
(718) 584-9000 ext 5129
Kel.morin@va.gov

Caitlyn Katzelnick (Kessler Institute) Research Coordinator
973-324-3588
ckatzelnick@kesslerfoundation.org

Alexander Lombard (Kessler Institute), Research Coordinator
973-324-3588
ALombard@kesslerfoundation.org

Chris Cirnigliano (Kessler Institute), Research Coordinator
(973) 731-3900 ext.2755
christopher.cirnigliaro@gmail.com