There are over 2.5 million people living worldwide with spinal cord injury (SCI), which is a complex and devastating neurological condition. In motor-complete injuries, exercise is restricted to the upper-limbs and an individual’s physical capacity or fitness is further limited by disrupted cardiovascular control. As such, in individuals with cervical and upper-thoracic SCI their bodies do not adapt appropriately to a bout of exercise, resulting in premature fatigue and a reduced physical capacity. Evidence has indicated that only 25% of individuals with paraplegia have the fitness necessary to maintain independent living. Moreover, it is well established that low fitness is a key risk factor for the development of cardiovascular disease, which is the number one cause of premature death in this population. In preliminary work, we have shown that an electrical stimulus applied by electrodes implanted over the spinal cord (epidural spinal cord stimulation) can modulate cardiovascular function (i.e., increase blood pressure) and can acutely improve exercise performance (PMID: 30635485). Indeed, emerging evidence demonstrates that non-invasive transcutaneous spinal cord stimulation (with electrodes applied over the skin to deliver electrical stimulation) can target the same spinal circuits as epidural spinal cord stimulation. Consequently, we propose a comprehensive program of clinical work investigating whether transcutaneous spinal cord stimulation is capable of improving cardiorespiratory fitness through the modulation of cardiovascular and motor functions in individuals with chronic SCI.
This is a 3.5-year project, commencing in September 2021. This experience and training provided at the University of Birmingham will allow the student to gain exposure to: cardiovascular assessments (e.g., continuous blood pressure monitoring, transcranial doppler), neuromodulation techniques (e.g., spinal cord stimulation, transcranial magnetic stimulation), blood sampling and biomarker analysis (e.g., using enzyme-linked immunosorbent assays), exercise testing and other aspects of human physiology (e.g., electromyography). In addition, during the first year the student will have the opportunity to visit the laboratory of collaborator Dr. Krassioukov (https://icord.org/researchers/dr-andrei-krassioukov/) at the University of British Columbia, Vancouver (Canada) for up to three months.
This project is suitable for applicants with a good first-class degree (at least 2:1) and preferably a Masters in a related topic area (e.g., neurosciences, biomedical sciences, exercise physiology) or equivalent research experience. The student should have an interest in haemodynamics and/or neuromodulation, and be highly motivated and self-directed. Experience in working with spinal cord injury would be an asset. Applications from medical or other allied health professionals are welcomed.
Applications must include CV, personal statement, and the contact details of two referees. Applications should be emailed to Dr. Tom Nightingale [Email Address Removed]. Please also contact Dr. Nightingale with informal inquiries regarding this studentship.
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