Most people think paralysis is the biggest challenge after a spinal cord injury (SCI). But a hidden complication can trigger sudden, life-threatening spikes in blood pressure that feel like a stroke. Witnessing such episodes in patients inspired Jan Elaine Soriano, now a postdoctoral fellow at the Swiss Federal Institute of Technology Lausanne, to ask a question that researchers had struggled to answer for decades: What if the nervous system could be retrained to stop these dangerous blood pressure surges before they begin?
Soriano’s work ultimately uncovered the circuitry behind those attacks in patients with SCI, along with a potential way to prevent them. This led to her winning the 2026 Science & PINS Prize for Neuromodulation.
“Her essay is a fantastic journey inside the life of a passionate young researcher,” said Mattia Maroso, senior editor at Science. “By leveraging neuroanatomical and functional techniques, Soriano and colleagues identified the aberrant neuronal architecture that causes the uncontrolled hypertension that develops after spinal cord injury.”
“The essay, which transforms a life-threatening crisis into a manageable signal, is a brilliant piece of work — scientifically rigorous and deeply humanistic,” said PINS Medical CEO Hao Hongwei.
Soriano was inspired to pursue this research by encounters during her graduate studies with patients with spinal cord injury who experienced autonomic dysreflexia, a potentially deadly complication of SCI that can be brought on by something as routine as a full bladder. “I saw firsthand how frightening and debilitating these episodes can be,” she said.
Autonomic dysreflexia, which results from the disconnection of the spinal cord from the rest of the nervous system, involves a sudden hypertensive crisis that can lead to a stroke. Symptoms range from sweating to headaches to cardiovascular disorders.
“When we see people with spinal cord injury, we always see these very visible consequences,” Soriano said. “But we don’t see these invisible consequences.”
During her studies, she was part of a clinical trial looking at blood pressure changes in people with SCI. “One of the patients I worked with said they thought they were going to pass out from a very bad headache,” she said. “We started asking him what he needed … That’s when I realized we couldn’t do anything but minimize those triggers.”
This realization motivated her to understand how neuromodulation could be used to avoid such triggers entirely, for SCI patients.
By mapping which neurons become overactive after spinal cord injury, Soriano discovered a previously unrecognized circuit that develops after injury.
She and her colleagues then developed a neuromodulatory therapy to target this architecture that prevents hypertensive episodes before they begin.
In subsequent experiments, starting in rodents and then moving into trials in patients, she found that spinal cord stimulation with this therapeutic approach appeared to retrain that circuitry, reducing the abnormal connections that trigger dangerous blood pressure spikes. “The [human] participants reported significantly fewer headaches and heart palpitations, two of the most prominent symptoms of autonomic dysreflexia,” Soriano said.
“I’m really excited about this work because it combines all modern neuroscience technology we have to address a problem people have been looking at for decades,” she said.
The therapeutic approach she and her colleagues designed is now in pivotal clinical trials of autonomic dysreflexia. The hope is that patients and their caregivers can understand warning signals while avoiding dangerous hypertensive crises.
by: Meagan Phelan
