Effects of 30-Day Midodrine Administration, Compared to Placebo, on Blood Pressure, Cerebral Blood Flow Velocity, and Cognitive Performance in Persons with SCI.
Individuals with spinal cord injury (SCI) at and above T6 experience impaired descending cortical control of the autonomic nervous system, which predisposes them to blood pressure (BP) disorders including persistent hypotension. The primary aim of this investigation was to determine the effects of m...
| Publicado en: | Topics in Spinal Cord Injury Rehabilitation Vol. 30; no. 4; pp. 45 - 57 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
KnowledgeWorks Global, Ltd
Fall2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=181134875&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 181134875 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10820744 0OF jtl: Topics in Spinal Cord Injury Rehabilitation issn: 10820744 maglogo: N pubinfo: dt: Fall2024 vid: 30 iid: 4 pid: 81084 pub: KnowledgeWorks Global, Ltd place: Richmond, Virginia artinfo: ui: 181134875 181134875 181134875 10.46292/sci23-00038 181134875 ppf: 45 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Effects of 30-Day Midodrine Administration, Compared to Placebo, on Blood Pressure, Cerebral Blood Flow Velocity, and Cognitive Performance in Persons with SCI. aug: au: Peters, Caitlyn G. Weir, Joseph P. Chiaravalloti, Nancy D. Dyson-Hudson, Trevor A. Kirshblum, Steven C. Wecht, Jill M. affil: James J. Peters VA Medical Center, Bronx, New York sug: subj: Spinal Cord Injuries Complications Hypotension, Orthostatic Drug Therapy Midodrine Therapeutic Use Midodrine Administration and Dosage Placebos Cerebrovascular Circulation Blood Flow Velocity Evaluation Cognition Evaluation Home Health Care Drug Administration Schedule Treatment Outcomes Systolic Pressure Evaluation Diastolic Pressure Evaluation Neuropsychological Tests Home Environment Human Male Female Randomized Controlled Trials Double-Blind Studies Crossover Design Prospective Studies Placebo Effect Comparative Studies Pretest-Posttest Control Group Design Descriptive Statistics Blood Pressure Evaluation Autonomic Dysreflexia Hemodynamics Quadriplegia Funding Source Data Analysis Software Confidence Intervals Heart Rate Adolescence Adult Middle Age United States Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Individuals with spinal cord injury (SCI) at and above T6 experience impaired descending cortical control of the autonomic nervous system, which predisposes them to blood pressure (BP) disorders including persistent hypotension. The primary aim of this investigation was to determine the effects of midodrine, 10 mg, administered daily over a 30-day period in the home environment, compared to placebo, on laboratory assessments of BP, cerebral blood flow velocity (CBFv), and cognitive performance in hypotensive individuals with chronic SCI. This prospective, randomized, placebo-controlled, double-blind, crossover trial was conducted in 15 individuals with tetraplegia. In the first 30-day period, five participants were randomized to midodrine and 10 were randomized to placebo; participants were then crossed over to the second 30-day period following a 14-day washout. Laboratory assessments of BP, CBFv, and cognitive performance were measured before and after each of the two study arms. Systolic BP (SBP) was significantly increased following midodrine administration compared to placebo (116 ± 23 mm Hg vs 94 ± 16 mm Hg; p =.002). In addition, diastolic CBFv was increased after midodrine administration compared to placebo (31.0 ± 11.2 vs 25.6 ± 9.1 cm/s; p =.04). However, there were no significant drug by time interaction effects for systolic or mean CBFv (p >.172) and cognitive performance (p =.689). The results suggest significant increases in SBP and diastolic CBFv without appreciable effects on cognition after 30 days of midodrine administration. Further investigation is needed to identify effective antihypotensive treatment options that not only normalize BP but also improve CBFv and cognition. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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