title: Review of Epidural Spinal Cord Stimulation for Augmenting Cough after Spinal Cord Injury.
abstract: Spinal cord injury (SCI) remains a debilitating condition for which there is no cure. In addition to loss of somatic sensorimotor functions, SCI is also commonly associated with impairment of autonomic function. Importantly, cough dysfunction due to paralysis of expiratory muscles in combination with respiratory insufficiency can render affected individuals vulnerable to respiratory morbidity. Failure to clear sputum can aggravate both risk for and severity of respiratory infections, accounting for frequent hospitalizations and even mortality. Recently, epidural stimulation of the lower thoracic spinal cord has been investigated as novel means for restoring cough by evoking expiratory muscle contraction to generate large positive airway pressures and expulsive air flow. This review article discusses available preclinical and clinical evidence, current challenges and clinical potential of lower thoracic spinal cord stimulation (SCS) for restoring cough in individuals with SCI.
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic Rochester, MN, USA.
authors.forename: Jan T
authors.initials: JT
authors.lastname: Hachmann
authors.affiliation: Mayo Clinic Graduate School of Biomedical Sciences Rochester, MN, USA.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Calvert
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic Rochester, MN, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Grahn
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic Rochester, MN, USA.
authors.forename: Dina I
authors.initials: DI
authors.lastname: Drubach
authors.affiliation: Department of Neurologic Surgery, Mayo ClinicRochester, MN, USA; Department of Physiology and Biomedical Engineering, Mayo ClinicRochester, MN, USA; Department of Physical Medicine and Rehabilitation, Mayo ClinicRochester, MN, USA.
authors.forename: Kendall H
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic Rochester, MN, USA.
authors.forename: Igor A
authors.initials: IA
authors.lastname: Lavrov
keywords: cough restoration; epidural spinal cord stimulation; functional electrical stimulation (FES); neuromodulation; neuroprosthetics; neurorestoration; spinal cord injury (SCI); spinal cord stimulation