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. 2016 Oct;232:54-6.
doi: 10.1016/j.resp.2016.07.001. Epub 2016 Jul 6.

High frequency spinal cord stimulation-New method to restore cough

K E Kowalski  1 , J R Romaniuk  2 , S W Brose  3 , M A Richmond  4 , T Kowalski  5 , A F DiMarco  6
Affiliations
Free PMC article

High frequency spinal cord stimulation-New method to restore cough

K E Kowalski et al. Respir Physiol Neurobiol. 2016 Oct.
Free PMC article

Abstract

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.

Keywords: Cough; Expiratory muscles; Rehabilitation; Spinal cord stimulation.

Figures

Fig. 1
Fig. 1
A - Comparison of 50Hz (LF-SCS) and 500Hz (HF-SCS) stimulation applied at the T9 spinal level on electromyographic (EMG) activities from the external oblique muscle (middle portion at the T13 spinal level) and positive airway pressure generation as a function of stimulus amplitude in representative animal. B - Mean airway pressure generation during LF-SCS (50Hz) with stimulus amplitudes of 15mA and 1mA and HF-SCS (500Hz) with a low stimulus amplitude of 1mA.
Fig. 2
Fig. 2
Relationships between stimulus amplitude and airway pressure generation at different stimulus frequencies during spinal cord stimulation at the T9 level. With increasing stimulus frequencies between 50 and 500Hz, there were increases in the magnitude of airway pressures. The maximum expiratory airway pressure was recorded during stimulus frequency of 500Hz.
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