Diaphragm activation via high frequency spinal cord stimulation in a rodent model of spinal cord injury

As demonstrated in a canine model, high frequency spinal cord stimulation (HF-SCS) is a novel and more physiologic method of electrical activation of the inspiratory muscles compared to current techniques. The dog model, however, has significant limitations due to cost and societal concerns. Since the rodent respiratory system is also a relevant model for the study of neuronal circuitry function, the aims of the present study were to a) assess the effects of HF-SCS and b) determine the methodology of application of this technique in rats. In 9 Sprague Dawley rats, diaphragm multiunit and single motor unit EMG activity were assessed during spontaneous breathing and HF-SCS applied on the ventral epidural surface of the spinal cord at the T2 level following C1 spinal section. As in dogs, HF-SCS results in the activation of the diaphragm at physiological firing frequencies and the generation of large inspired volumes. Mean maximum firing frequencies of the diaphragm during spontaneous breathing and HF-SCS were 23.3 ± 1.4 Hz (range: 9.8-51.6 Hz) and 26.6 ± 1.3 Hz; range: 12.0-72.9 Hz, respectively, at comparable inspired volumes. Moreover, HF-SCS was successful in pacing these animals over a 60-min period without evidence of system fatigue. Our results suggest that, similar to the dog model, HF-SCS in the rat results in the activation of spinal cord tracts which synapse with the phrenic motoneuron pool, allowing the processing of the stimulus and consequent physiologic activation of the inspiratory muscles. The rat may be a useful model for further studies evaluating phrenic motoneuron physiology.