High Frequency Spinal Cord Stimulation – New Method to Restore Cough

Respir Physiol Neurobiol, 2016 · DOI: 10.1016/j.resp.2016.07.001 · Published: October 1, 2016

Spinal Cord Injury Physiology Neurorehabilitation

Simple Explanation

This study explores a new method to help people with spinal cord injuries and other neuromuscular diseases regain their ability to cough effectively. Coughing helps clear secretions from the lungs, preventing respiratory complications. The traditional method, using spinal cord stimulation (SCS) at 50Hz, requires high stimulus amplitudes, which can cause discomfort. This research investigates high-frequency SCS (HF-SCS) with low stimulus amplitudes as a potential alternative. The study found that HF-SCS (500Hz) at low stimulus amplitudes (1mA) produced similar airway pressures to conventional SCS (50Hz at 15mA) in dogs, suggesting it could be a viable method to restore cough function even in individuals with intact sensation.

Study Duration

Not specified

Participants

6 mongrel dogs

Evidence Level

Animal study

Key Findings

1
At any given level of stimulus current below 2mA, airway pressure generation was substantially larger at 500Hz compared to 50Hz.
2
Mean airway pressure generation during LF-SCS (50Hz, 15mA) was not significantly different than that achieved with HF-SCS (500Hz, 1mA).
3
Maximum airway pressure was generated at 500Hz with 1mA stimulation (58 ± 4cmH2O).

Research Summary

The study investigates the potential of high-frequency spinal cord stimulation (HF-SCS) to restore cough function in individuals with neuromuscular diseases, addressing the limitations of conventional low-frequency SCS (LF-SCS). Experiments on dogs demonstrated that HF-SCS (500Hz) with low stimulus amplitudes (1mA) can achieve comparable airway pressures to LF-SCS (50Hz, 15mA), indicating its potential to activate expiratory muscles effectively. The findings suggest that HF-SCS could be a valuable method for restoring cough in various patient populations, including those with intact sensation, who cannot tolerate the high stimulus amplitudes required by conventional SCS.

Practical Implications

Improved Cough Restoration

HF-SCS may offer a more comfortable and effective method for restoring cough function in patients with neuromuscular diseases compared to traditional methods.

Broader Patient Applicability

The lower stimulus amplitudes required by HF-SCS make it a potential option for individuals with intact sensation, expanding the range of patients who could benefit from spinal cord stimulation for cough assistance.

Reduced Respiratory Complications

By restoring effective cough, HF-SCS could reduce the incidence of respiratory tract infections and improve the overall quality of life for patients with expiratory muscle weakness.

Study Limitations

1
Animal study, results may not directly translate to humans
2
The specific mechanisms of expiratory muscle activation via HF-SCS are not fully understood
3
Further research is needed to determine optimal electrode placement and minimize injected current

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