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Published on: June 26, 2018
High frequency spinal cord stimulation-New method to restore cough.
K E Kowalski1, J R Romaniuk2, S W Brose3
1Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA; Department of Medicine, Case Western Reserve University, Cleveland, OH, USA; MetroHealth Research Institute, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, USA.
High-frequency spinal cord stimulation (HF-SCS) effectively restores cough in spinal cord injury (SCI) patients. This method uses lower stimulus amplitudes, potentially avoiding pain fiber activation and improving safety.
Area of Science:
- Neuromodulation
- Respiratory Physiology
- Spinal Cord Injury Rehabilitation
Background:
- Spinal cord stimulation (SCS) at 50Hz aids cough restoration in spinal cord injury (SCI).
- High stimulus amplitudes and pain fiber activation limit conventional SCS efficacy.
- Investigating high-frequency SCS (HF-SCS) as a potentially safer alternative.
Purpose of the Study:
- To test the hypothesis that HF-SCS can achieve comparable expiratory muscle activation with lower stimulus amplitudes.
- To evaluate the effects of varying SCS frequencies and amplitudes on positive pressure (P) generation.
Main Methods:
- Six dogs were used to assess SCS effects on positive pressure (P) generation.
- Stimulus parameters including frequency (200-600Hz) and current (1mA) were varied.
- Positive pressure (P) was measured to quantify expiratory muscle activation.
Main Results:
- Mean P was highest at 500Hz across tested frequencies at a given stimulus current.
- HF-SCS at 500Hz and 1mA produced P of 58±4 cmH2O, comparable to conventional SCS (61±5 cmH2O).
- HF-SCS achieved similar P generation with significantly lower stimulus amplitudes.
Conclusions:
- HF-SCS can generate effective expiratory muscle activation for cough restoration.
- This approach may offer a safer alternative to conventional SCS by using lower stimulus amplitudes.
- HF-SCS holds promise for restoring cough in SCI individuals, including those with intact sensation.
