title: Safety assessment of epidural wire electrodes for cough production in a chronic pig model of spinal cord injury.
abstract: It is our hypothesis that high intensity spinal cord stimulation (SCS) to restore an effective cough mechanism using wire leads, will result in significant activation of target neurons without tissue injury or electrode corrosion.
  
  
  
  Adult mini-pigs underwent chronic spinal cord compression, followed by implantation of parallel wire leads on the dorsal epidural surface of the spinal cord, with stimulation contacts at the T9 and T12, and control electrode contacts at the T2 and T5 levels. After 3 months of daily SCS, airway pressure generation (P), tissue in the area of the stimulating and control electrodes and electrode leads were examined. P was also assessed in acute animals, which served as controls.
  
  
  
  Mean P at FRC was 54±5cmH2O and 109±11cmH2O in the control and chronically stimulated animals, respectively (p<0.05). There was minimal tissue reaction in the area of the stimulating and control electrodes. All sets of leads revealed no evidence of electrode corrosion.
  
  
  
  Previous porcine models of chronic spinal cord injury (SCI) were developed to study neurological and regenerative outcomes. Our method of chronic SCI porcine model was developed to evaluate the safety of electrical SCS to restore expiratory muscle function.
  
  
  
  Chronic SCS with wire lead electrodes results in significant increases in P without evidence of significant adverse tissue reaction, nor evidence of electrode corrosion. This method may be a safe and useful technique to restore a functional cough in spinal cord injured subjects.
authors.affiliation: MetroHealth Medical Center, Cleveland, OH 44106, USA; Case Western Reserve University, Cleveland, OH 44106, USA; Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH 44106, USA. Electronic address: kek5@case.edu.
authors.forename: Krzysztof E
authors.initials: KE
authors.lastname: Kowalski
authors.affiliation: MetroHealth Medical Center, Cleveland, OH 44106, USA; Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH 44106, USA. Electronic address: tomkowalski4@gmail.com.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Kowalski
authors.affiliation: MetroHealth Medical Center, Cleveland, OH 44106, USA; Case Western Reserve University, Cleveland, OH 44106, USA. Electronic address: afd3@case.edu.
authors.forename: Anthony F
authors.initials: AF
authors.lastname: DiMarco
mesh_terms: D000399:Air Pressure; D000818:Animals; D002945:Cisplatin; D003371:Cough / Q000473:pathology / Q000503:physiopathology; D004195:Disease Models, Animal; D004558:Electric Stimulation / Q000295:instrumentation / Q000379:methods; D004567:Electrodes, Implanted; D004824:Epidural Space; D004869:Equipment Safety; D007495:Iridium; D008176:Lung Volume Measurements; D008855:Microscopy, Electron, Scanning; D012132:Respiratory Muscles / Q000503:physiopathology; D013116:Spinal Cord / Q000473:pathology / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000473:pathology / Q000503:physiopathology; D013552:Swine; D013556:Swine, Miniature / Q000502:physiology; D013904:Thoracic Vertebrae
chemical_list: D007495:Iridium; D002945:Cisplatin
keywords: Electrical stimulation; Expiratory muscles; Rehabilitation; Safety