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Dorsal column stimulation

Effect on human cerebrospinal fluid and plasma catecholamines

Departments of Neurosciences (Dr. Levin) and Neurosurgery (Dr. Hubschmann), East Orange Veterans Administration Medical Center, and the College of Medicine and Dentistry of New Jersey—New Jersey Medical School, East Orange, NJ.

Plasma and cerebrospinal fluid catecholamines were measured in three patients with multiple sclerosis who had dorsal column stimulators placed at the T5–7 levels. Stimulation for 3 minutes and 20 minutes increased release of plasma norepinephrine, epinephrine, and dopamine, as well as norepinephrine into the cerebrospinal fluid. Neither dopamine nor epinephrine was released into the spinal fluid during or after stimulation. Percutaneous stimulation did not release catecholamines into the plasma or spinal fluid, suggesting that these findings were not simply related to sensory stimulation or stress. Plasma catecholamine levels were inconsistently correlated with pulse rate changes during and after stimulation but not with blood pressure, although the changes in pulse rate and blood pressure were relatively small compared to changes in plasma catecholamines. This study suggests that plasma catecholamines and spinal fluid norepinephrine reflect central activation of sympathetic nervous system pathways and are more reliable indicators of sympathetic activity than changes in cardiovascular function.

Address reprint requests to Dr. Levin, Neurology Service (127). Veterans Administration Medical Center, East Orange, NJ 07019.

Accepted for publication May 23, 1979.

Supported by the Medical Research Service of the Veterans Administration and the Foundation of the College of Medicine and Dentistry of New Jersey.