title: High frequency spinal cord stimulation-New method to restore cough.
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.
authors.affiliation: Research 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. Electronic address: kek5@case.edu.
authors.forename: K E
authors.initials: KE
authors.lastname: Kowalski
authors.affiliation: Research Service, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Romaniuk
authors.affiliation: Department of Spinal Cord Injury, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA; Department of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, OH, USA; Ohio University Heritage College of Osteopathic Medicine, Cleveland, OH, USA.
authors.forename: S W
authors.initials: SW
authors.lastname: Brose
authors.affiliation: Department of Spinal Cord Injury, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA; Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Richmond
authors.affiliation: MetroHealth Research Institute, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, USA.
authors.forename: T
authors.initials: T
authors.lastname: Kowalski
authors.affiliation: Department of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, OH, USA; MetroHealth Research Institute, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, USA.
authors.forename: A F
authors.initials: AF
authors.lastname: DiMarco
mesh_terms: D000200:Action Potentials; D000818:Animals; D055592:Biophysical Phenomena / Q000502:physiology*; D045422:Continuous Positive Airway Pressure; D003371:Cough / Q000209:etiology / Q000628:therapy* / Q000662:veterinary*; D004195:Disease Models, Animal; D004285:Dogs; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology; D005652:Functional Residual Capacity / Q000502:physiology; D007796:Laminectomy; D012132:Respiratory Muscles / Q000502:physiology; D013119:Spinal Cord Injuries / Q000150:complications; D062187:Spinal Cord Stimulation / Q000379:methods*
keywords: Cough; Expiratory muscles; Rehabilitation; Spinal cord stimulation