# Targeted Transcutaneous Stimulation to Restore Autonomic Cardiovascular Health in Veterans with Spinal Cord Injury

> **NIH VA IK1** · JAMES J PETERS VA  MEDICAL CENTER · 2022 · —

## Abstract

PROJECT SUMMARY/ABSTRACT
Dr. Caitlyn Katzelnick has been working with investigators in the National Center for Spinal
Cord Injury (SCI) and Immobilizing Conditions at the VA Medical Center, Bronx, NY for eight
years as a senior research coordinator. Along with her Primary Mentor, Dr. Wecht, Caitlyn has
been studying the effects of cardiovascular, cerebrovascular and cognitive dysfunction post SCI,
and the results of her Doctoral dissertation suggest that increased arterial stiffness in
individuals with SCI may relate to the degree of decentralized sympathetic cardiovascular
control and increased reliance on the renin-angiotensin-aldosterone system (RAAS) for
maintenance of orthostatic blood pressure (BP). Recent evidence indicates that increased
arterial stiffness is an independent predictor of cardiovascular disease risk, which may
contribute to the heightened cardiovascular morbidity and mortality in the SCI, compared to the
general population. Increased reliance on the RAAS is believed to mitigate orthostatic falls in
BP and reduce the severity of symptoms reporting; however, findings in the general population
link the RAAS with vascular restructuring and remodeling. Therefore, clinical intervention to
stabilize and normalize BP should be a priority in hypotensive individuals with SCI. Advances in
methods of neuromodulation of the spinal processes offer a non-pharmacologic approach to
restore endogenous autonomic cardiovascular control and improve orthostatic BP control.
Based on our present understanding of the somatovisceral integration within the spinal cord, it
is plausible that transcutaneous spinal cord stimulation (TSCS) can be targeted to excite and
modulate appropriate spinal autonomic circuitry to rapidly normalize orthostatic BP; however,
electrode placement and stimulation parameter mapping is needed to optimize orthostatic BP
control. Therefore, our primary aim is to identify an individualized map using noninvasive
TSCS of the spinal autonomic circuitry that results in an increase of seated BP. Our secondary
aim is to compare BP, plasma concentrations of norepinephrine, renin and aldosterone during a
head-up tilt with and without optimal TSCS. This investigation will be completed at the brand-
new Center of Spinal Stimulation, located at the Kessler Foundation, which is home to our VA
satellite center. Dr. Katzelnick will have access to all the necessary facilities and equipment
including: TSCS, electromyography (EMG) and cardiovascular. The CDA-1 will provide Dr.
Katzelnick with the advanced skill training, clinical research experience, and mentorship to
facilitate her growth into an independent VA investigator. Training objectives include: 1)
administering and mapping TSCS; 2) gaining an understanding of EMG recordings and
analysis; and 3) assaying the RAAS hormones. Dr. Katzelnick will take academic courses to
advance her knowledge base in grant writing, cardiovascular physiology, statistics, biophysics
and EMG. Her mentors enc...

## Key facts

- **NIH application ID:** 10418182
- **Project number:** 1IK1RX003706-01A2
- **Recipient organization:** JAMES J PETERS VA  MEDICAL CENTER
- **Principal Investigator:** Caitlyn G. Peters
- **Activity code:** IK1 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10418182

## Citation

> US National Institutes of Health, RePORTER application 10418182, Targeted Transcutaneous Stimulation to Restore Autonomic Cardiovascular Health in Veterans with Spinal Cord Injury (1IK1RX003706-01A2). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10418182. Licensed CC0.

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