It may not be intuitive to many of us that don’t have a spinal cord injury, and can't immediately understand the severity of the disability beyond what they see with the naked eye, but there are many hidden consequences of this condition. Although we all observe that there is certainly paralysis and loss of movement, people with spinal cord injury live on a daily basis with dysfunction of the unconscious bodily systems that most of us tend to take for granted. These functions are collectively called autonomic, in that because they are largely operated by centres in our brain that are most commonly unconscious, in medicine they are often considered autonomous. These functions include many of the bodily systems required for basic daily living, such as stable blood pressure so that our brains and hearts can function, bladder and bowel control so that we do not leak or store waste inappropriately, and the loss of sexual function which can permeate into all aspects of life. After reading this it is likely not surprising that these issues are consistently reported as being more important than walking again to people living with spinal cord injury. The Phillips Lab team is focused on understanding and solving these issues.
2018 (Phillips Lab members in bold)
Is Technology for Orthostatic Hypotension Ready for Primetime? Sarafis ZK, Monga AK, Phillips AA, Krassioukov AV. PM R. 2018 Sep;10(9S2):S249-S263. doi: 10.1016/j.pmrj.2018.04.011
Spinal cord disruption is associated with a loss of Cushing-like blood pressure interactions Saleem S, Sarafis Z, Lee AHX, Squair JW, Barak OF, Coombs GB, Mijacika T, Krassioukov AV, Ainslie PN, Dujic Z, Tzeng YC, Phillips AA. J Neurotrauma. Accepted
Reduced colonic smooth muscle cholinergic responsiveness is associated with impaired bowel motility after chronic experimental high-level spinal cord injury #Frias B, #Phillips AA, Squair JW, Lee AHX, Laher I, Krassioukov AV. #Co-first author. Autonomic Neuroscience: Basic and Clinical. Accepted
Minocycline reduces the severity of autonomic dysreflexia after experimental spinal cord injury. Squair JW, Ruiz IA, Phillips AA, Zheng MM, Sarafis Z, Sachdeva R, Gopaul R, Liu J, Tetzlaff W, West CR, Krassioukov AV. J Neurotrauma. 2018 Aug 16. doi: 10.1089/neu.2018.5703.
Effect of healthy ageing on cerebral blood flow, CO2 reactivity and neurovascular coupling during exercise. Nowak-Flück D, Ainslie PN, Bain AR, Ahmed A, Wildfong KW, Morris LE, Phillips AA, Fisher JP. J Appl Physiol (1985). 2018 Jun 7. doi: 10.1152/japplphysiol.00050.2018. [Epub ahead of print] PMID: 29878868
Wavelet decomposition analysis is a clinically relevant strategy to evaluate cerebrovascular buffering of blood pressure after spinal cord injury Saleem S, Vucina D, Sarafis Z, Lee AHX, Squair JW, Barak OF, Coombs GB, Mijacika T, Krassioukov AV, Ainslie PN, Dujic Z, Tzeng YC, Phillips AA. Am J Physiol Heart Circ Physiol.
To perturb or not to perturb: a novel physiological approach using closed-loop feedback to understand feedback systems. Darrow D, Phillips AA. Journal of Physiology. 2018
Association of Epidural Stimulation With Cardiovascular Function in an Individual With Spinal Cord Injury #West CR, #Phillips AA, Squair JW, Williams AM, Walter M, Lam T, Krassioukov AV. #Co-first author JAMA Neurology
Journal Club: Relationship between carotid arterial properties and cerebral white matter hyperintensities. Squair JW, Field TS, Phillips AA. Neurology
Alarming blood pressure changes during routine bladder emptying in a woman with cervical spinal cord injury. Lee AHX, Phillips AA, Squair JW, Barak OF, Coombs GB, Ainslie PN, Sarafis ZK, Mijacika, Vucina, Dujic Z, Krassioukov AV. Spinal Cord Ser Cases.
Transient Hypertension after Spinal Cord Injury Leads to Cerebrovascular Endothelial Dysfunction and Fibrosis. Phillips AA, Matin N, Jia M, Squair JW, Monga A, Zheng MMZ, Sachdeva R, Yung A, Hocaloski S, Elliott S, Kozlowski P, Dorrance AM, Laher I, Ainslie PN, Krassioukov AV. J Neurotrauma
Incidence and Natural Progression of Neurogenic Shock after Traumatic Spinal Cord Injury. Ruiz IA, Squair JW, Phillips AA, Lukac CD, Huang D, Oxciano P, Yan D, Krassioukov AV. J Neurotrauma
An Autonomic Neuroprosthesis: Noninvasive Electrical Spinal Cord Stimulation Restores Autonomic Cardiovascular Function in Individuals with Spinal Cord Injury. Phillips AA, Squair JW, Sayenko DG, Edgerton VR, Gerasimenko Y, Krassioukov AV. J Neurotrauma
My research intersects integrated physiology and neuroscience in order to understand cardiovascular function. Currently, the laboratory has two primary foci: the first is to understand the mechanisms underlying neurovascular regulation in the human brain; the second is to develop a neurostimulation therapy for restoring cardiovascular health in those with autonomic dysfunction.
I am currently working with interdisciplinary teams of scientists, clinicians, and engineers in Switzerland (EPFL), Croatia (Split Medical School), and the USA (University of Minnesota) to deeply understand the capacity of electrical stimulation of the spinal cord to control autonomic function. These studies are using murine models, as well as non-human primates and humans.
Clinical tools used in the lab include vascular and cardiac ultrasound, beat-by-beat blood pressure, MRI, orthostatic stress testing, arterial blood gas reactivity testing, both surgically implanted and non-invasive neurostimulation modalities, etc. Preclinical tools include various tissue clearing methods (CLARITY, uDISCO) arterial cannulation, nerve recordings, spinal cord transection/contusion, and a variety of genetic strains for manipulation (e.g., Th-Cre, PV-Cre). The lab is also employing a novel computational pipeline for managing large data-sets of physiological metrics.