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Abstract
Introduction Cerebral blood flow (CBF) is regulated by several mechanisms. Neurogenic control has been a matter of debate, even though several publications reported the effects of changes in sympathetic tone on CBF. Transcutaneous electrical nerve stimulation and spinal-cord stimulation have been shown to influence peripheral and cerebral blood flow through a sympathetic pathway. The authors hypothesise that certain pathological conditions result in a relative increase in the neurogenic regulation of CBF and that this regulation can be modulated electrically.
Methods and analysis Patients with cerebral vasospasm after subarachnoid haemorrhage will be included. The experimental set-up measures several parameters that are involved in cerebral blood flow regulation in patients with cerebral vasospasm after subarachnoid haemorrhage. Measurements are taken at baseline and with stimulation in several frequencies. An ad hoc statistical analysis is used to evaluate different settings of the electrical stimulation. Autoregulation is evaluated with transfer function analysis and autoregulatory index calculations.
Ethics and dissemination Ethical registration was granted by Medical Review Ethics Committee Groningen (ID METc 2010.123). All participants provide written informed consent on participation. Upon finishing a pilot study to investigate feasibility and effect, either future prospective (randomised) studies will be designed, or other modalities of electrical stimulation will be explored using the same set-up.
Trial Registration Dutch Trial Registry: NTR2358.
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Footnotes
To cite: Ter Laan M, van Dijk JMC, Staal MJ, et al. Electrical modulation of the sympathetic nervous system in order to augment cerebral blood flow: a protocol for an experimental study. BMJ Open 2011;1:e000120. doi:10.1136/bmjopen-2011-000120
Competing interests None.
Ethics approval Ethics approval was provided by the Medical Review Ethics Committee Groningen (ID METc 2010.123).
Contributors MTL participated in the developing and testing of the study set-up, designed the statistical and mathematical analysis, and drafted the manuscript; JMCvD and MJS contributed to the conception of the study and critically reviewed the manuscript; J-WJE participated in the developing and testing of the study set-up, especially data collection and integration, contributed to the conception of the study and participated in drafting the manuscript. All authors read and approved the final manuscript.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Mathematical synthax, statistical code, and dataset will be available after termination of the study from the corresponding author. Specific consent for data sharing will not be obtained because the presented data are anonymised and risk of identification is low.