Neuromodulation Of Cerebral Blood Flow By Electrical Stimulation: Is There a Clinical Indication?

Abstract

After the demonstration that spinal cord stimulation (SCS) can improve peripheral blood flow, Hosobuchi in 1986 first studied the effect of SCS on cerebral blood flow (CBF) in human beings. Our group found that SCS can produce either an increase of CBF, a reduction, or no effect at all. In patients studied with both SPECT and TCD, induced variations, when present in both, was the same. A reduction of CBF is very rare and occurs when electrodes are place in a more caudal location, while cervical stimulation produces, more frequently, an increase in CBF (61% of cervical stimulations). Autoregulatory tests performed in our laboratory on SCS patients, before and during stimulation, suggested that SCS and CO2 interact with the mechanism of regulation of CBF in a competitive way. We confirmed the SCS’s effect on CBF in rabbits suggesting that a reversible functional sympathectomy occurs during SCS.