Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.


Interdisciplinary and Graduate Studies

Degree Program

Interdisciplinary Studies with a specialization in Translational Neuroscience, PhD

Committee Chair

Terson de Paleville, Daniela

Committee Member

Magnuson, David

Committee Member

Castillo, Camilo

Committee Member

Lorenz, Douglas

Committee Member

Joshua, Irving

Committee Member

Pantalos, George

Author's Keywords

spinal cord injury; blood pressure; heart rate variability; biofeedback; breathing; autonomic


There is an immediate need for fast-acting blood pressure (BP) modification without the side effects of pharmaceutical interventions for people with cervical spinal cord injuries (SCI), who often suffer from dangerous increases and decreases in BP.1,2 First, we compared mental to virtual reality (VR) imagery with the addition of breathing exercises and guided interoceptive attention, investigating participants’ ability to volitionally change their BP and heart rate variability (HRV), alternating three-minute stimulating and relaxing training cycles in 17 noninjured (NI) participants and 14 participants with SCI. Second, we trained 13 people with SCI and seven NI control participants for one hour per session with eight training sessions over one month. Participants’ feedback goal was to increase then decrease their mean arterial pressure (MAP) by at least five millimeters of Mercury (mmHg). Participants with SCI had successful relaxation cycles 62% of the time and successful stimulation cycles 60% of the time. NI participants had successful relaxation cycles 80% of the time and successful stimulation cycles 78% of the time. Mean increases and decreases in MAP in all cycles were significantly greater than five mmHg with successful cycle mean changes ranging from 9.5-10.92 mmHg. Significant improvements in both time and frequency domain HRV measurements correlated with increased BP variability in all participants. Autonomic biofeedback using mental and/or VR imagery could be an effective adjunct tool for fast-acting, non-pharmaceutical BP modification and HRV improvement for people with and without SCI.