Elaine Soriano†, Rémi Hudelle†, Loïs Mahé, Matthieu Gautier, Yue Yang Teo, Michael A. Skinnider, Achilleas Laskaratos, Steven Ceto, Claudia Kathe, Thomas Hutson, Rebecca Charbonneau, Fady Girgis, Steve Casha, Julien Rimok, Marcus Tso, Kelly Larkin-Kaiser, Nicolas Hankov, Aasta Gandhi, Suje Amir, Xiaoyang Kang, Yashwanth Vyza, Eduardo Martin-Moraud, Stephanie Lacour, Robin Demesmaeker, Leonie Asboth, Quentin Barraud, Mark A. Anderson, Jocelyne Bloch, Jordan W. Squair, Aaron A. Phillips, Grégoire Courtine, A neuronal architecture underlying autonomic dysreflexia, Nature (2025)
Abstract
Autonomic dysreflexia is a life-threatening medical condition characterized by episodes of uncontrolled hypertension triggered by sensory stimuli following spinal cord injury (SCI). The limited understanding of its underlying mechanisms has hindered therapeutic progress, exposing individuals with SCI to daily risks of heart attack and stroke. Our study reveals the aberrant neuronal architecture responsible for autonomic dysreflexia after SCI, while simultaneously identifying a competing yet overlapping neural network—activated through epidural electrical stimulation—that safely restores blood pressure regulation. The discovery that these opposing systems converge on a shared neuronal subpopulation enabled us to develop a targeted intervention that successfully reversed autonomic dysreflexia in mice, rats, and humans with SCI. These findings lay the groundwork for pivotal clinical trials to validate epidural electrical stimulation as a safe and effective treatment for autonomic dysreflexia in people living with SCI.
Link to the article : https://www.nature.com/articles/s41586-025-09487-w