High frequency spinal cord stimulation—New method to restore cough

• Published in: Respiratory physiology & neurobiology Vol. 232; pp. 54 - 56
• Main Authors: Kowalski, K.E., Romaniuk, J.R., Brose, S.W., Richmond, M.A., Kowalski, T., DiMarco, A.F.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2016
• Subjects: Action Potentials; Animals; Biophysical Phenomena - physiology; Continuous Positive Airway Pressure; Cough; Cough - etiology; Cough - therapy; Cough - veterinary; Disease Models, Animal; Dogs; Electromyography; Evoked Potentials, Motor - physiology; Expiratory muscles; Functional Residual Capacity - physiology; Laminectomy; Medical Education; Pulmonary/Respiratory; Rehabilitation; Respiratory Muscles - physiology; Spinal Cord Injuries - complications; Spinal cord stimulation; Spinal Cord Stimulation - methods; Expiratory muscles; Rehabilitation; Cough; Spinal cord stimulation
• ISSN: 1569-9048; 1878-1519; 1878-1519
• DOI: 10.1016/j.resp.2016.07.001

•HF-SCS with low stimulus amplitudes causes marked expiratory muscle activation.•HF-SCS results in the generation of large airway pressures typical of a normal cough.•This method may be an important clinical tool for restoration of an effective cough. Spinal cord stimulation (SCS, 50Hz) is a useful method to restore an effective cough in persons with spinal cord injury (SCI). However, high stimulus amplitudes and potential activation of pain fibers, significantly limits this application. It is our hypothesis that high frequency SCS (HF-SCS), with low stimulus amplitudes may provide the same level of expiratory muscle activation. In 6 dogs, the effects of SCS, with varying stimulus parameters on positive pressure (P) generation was evaluated. At any given level of stimulus current, mean P was largest at 500Hz, compared to all other stimulus frequencies. For example, with stimulation at 1mA and frequencies of 200, 500 and 600Hz, P were 25±3, 58±4, 51±6cmH2O, respectively. By comparison, P achieved with conventional SCS parameters was 61±5cmH2O. HF-SCS results in a comparable P compared to that achieved with conventional stimulus parameters but with much lower stimulus amplitudes. This method may be useful to restore cough even in subjects with intact sensation.