The Role of Androgens in Neurophysiological and Autonomic Function in Male Veterans With Spinal Cord Injury
VA Office of Research and Development
Summary
Spinal cord injury (SCI) disrupts the nerves controlling movement, along with those that regulate functions like heart rate and blood pressure (known as the autonomic nervous system, or ANS). Testosterone (T) plays a significant role in brain health and ANS reflex function in non-neurologically impaired men. However, little is known about the relationships between T, nerve function, and ANS dysfunction after SCI. Interestingly, up to 60% of men with SCI exhibit persistently low T concentrations, which may worsen nerve and ANS dysfunction. In uninjured eugonadal people (normal physiologic range of serum T concentrations), a single pharmacologic dose of intranasal T has been shown to quickly improve nerve function, but no study has evaluated if T administration alters nerve and ANS function in men with SCI. Herein, the investigators will conduct the first study to test how a single dose of intranasal T impacts motor and ANS function in this population.
Description
Spinal cord injury (SCI) disrupts sensorimotor function and corticospinal excitability, resulting in muscle weakness and autonomic nervous system (ANS) dysfunction that detracts from cardiovascular (CV) health. These deficits may be exacerbated by low testosterone (T), which develops in most men during the acute/subacute phases of SCI and persists in 45-60% of men thereafter. Low T (hypogonadism) is associated with multiple health impairments, including reduced lean tissue mass and increased fat mass, systemic inflammation, and risk for CV and neurodegenerative diseases. Moreover, low T is ass…
Eligibility
- Age range
- 18–80 years
- Sex
- Male
- Healthy volunteers
- Yes
Inclusion Criteria: * Male * Hypogonadal (Serum Total T \<300 ng/dL, Free T \<46 pg/mL, or bioavailable T \<110 ng/dL) with signs/symptoms of hypogonadism * Age 18-80 years * Traumatic or non-traumatic spinal cord injury (SCI) * Time since injury (TSI) more than 12 months * American Spinal Injury Association (ASIA) Injury classification Scale (AIS) A, B, C, or D * Stable prescription medication regimen for at least 30 days * Not currently receiving pharmacological treatment for hypogonadism * Must be able to commit to study requirements of 3 visits within a 30-day period * Provide informed co…
Interventions
- DrugNatesto testosterone intranasal gel
A single dose of Natesto (11 mg total, 5.5 mg per nostril) will be administered to each participant.
- DrugAyr Saline Nasal Gel
A single dose of Ayr (one spray per nostril) will be administered to each participant.
Location
- James J. Peters VA Medical Center, Bronx, NYThe Bronx, New York