Review of Epidural Spinal Cord Stimulation for Augmenting Cough After Spinal Cord Injury

Overview

Journal Front Hum Neurosci

Specialty Neurology

Date 2017 Apr 13

PMID 28400726

Citations 5

Authors

Jan T Hachmann

Jonathan S Calvert

Peter J Grahn

Dina I Drubach

Kendall H Lee

Igor A Lavrov

Affiliations

Soon will be listed here.

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.

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References

Davis J, Plum F . Separation of descending spinal pathways to respiratory motoneurons. Exp Neurol. 1972; 34(1):78-94. DOI: 10.1016/0014-4886(72)90189-6. View

Iscoe S . Control of abdominal muscles. Prog Neurobiol. 1998; 56(4):433-506. DOI: 10.1016/s0301-0082(98)00046-x. View

Jefferson S, Tester N, Rose M, Blum A, Howland B, Bolser D . Cough following low thoracic hemisection in the cat. Exp Neurol. 2010; 222(1):165-70. PMC: 2834262. DOI: 10.1016/j.expneurol.2009.12.015. View

Schilero G, Grimm D, Bauman W, Lenner R, Lesser M . Assessment of airway caliber and bronchodilator responsiveness in subjects with spinal cord injury. Chest. 2005; 127(1):149-55. DOI: 10.1378/chest.127.1.149. View

Collinger J, Foldes S, Bruns T, Wodlinger B, Gaunt R, Weber D . Neuroprosthetic technology for individuals with spinal cord injury. J Spinal Cord Med. 2013; 36(4):258-72. PMC: 3758523. DOI: 10.1179/2045772313Y.0000000128. View

Estenne M, Van Muylem A, Gorini M, Kinnear W, Heilporn A, De Troyer A . Evidence of dynamic airway compression during cough in tetraplegic patients. Am J Respir Crit Care Med. 1994; 150(4):1081-5. DOI: 10.1164/ajrccm.150.4.7921440. View

Decima E, VON EULER C, Thoden U . Intercostal-to-phrenic reflexes in the spinal cat. Acta Physiol Scand. 1969; 75(4):568-79. View

Van Houtte S, Vanlandewijck Y, Gosselink R . Respiratory muscle training in persons with spinal cord injury: a systematic review. Respir Med. 2006; 100(11):1886-95. DOI: 10.1016/j.rmed.2006.02.029. View

Ragnarsson K . Functional electrical stimulation after spinal cord injury: current use, therapeutic effects and future directions. Spinal Cord. 2007; 46(4):255-74. DOI: 10.1038/sj.sc.3102091. View

10.

Lin K, Lai Y, Wu H, Wang T, Wang Y . Effects of an abdominal binder and electrical stimulation on cough in patients with spinal cord injury. J Formos Med Assoc. 1998; 97(4):292-5. View

11.

DeVivo M, Krause J, Lammertse D . Recent trends in mortality and causes of death among persons with spinal cord injury. Arch Phys Med Rehabil. 1999; 80(11):1411-9. DOI: 10.1016/s0003-9993(99)90252-6. View

12.

Langlands J . The dynamics of cough in health and in chronic bronchitis. Thorax. 1967; 22(1):88-96. PMC: 471594. DOI: 10.1136/thx.22.1.88. View

13.

DiMarco A, Kowalski K, Geertman R, Hromyak D, Frost F, Creasey G . Lower thoracic spinal cord stimulation to restore cough in patients with spinal cord injury: results of a National Institutes of Health-Sponsored clinical trial. Part II: clinical outcomes. Arch Phys Med Rehabil. 2009; 90(5):726-32. PMC: 2809374. DOI: 10.1016/j.apmr.2008.11.014. View

14.

De Troyer A, Gilmartin J, Ninane V . Abdominal muscle use during breathing in unanesthetized dogs. J Appl Physiol (1985). 1989; 66(1):20-7. DOI: 10.1152/jappl.1989.66.1.20. View

15.

De Troyer A, Estenne M, Ninane V, Van Gansbeke D, Gorini M . Transversus abdominis muscle function in humans. J Appl Physiol (1985). 1990; 68(3):1010-6. DOI: 10.1152/jappl.1990.68.3.1010. View

16.

Butler J, Lim J, Gorman R, Boswell-Ruys C, Saboisky J, Lee B . Posterolateral surface electrical stimulation of abdominal expiratory muscles to enhance cough in spinal cord injury. Neurorehabil Neural Repair. 2010; 25(2):158-67. DOI: 10.1177/1545968310378509. View

17.

Spivak E, Keren O, Niv D, Levental J, Steinberg F, Barak D . Electromyographic signal-activated functional electrical stimulation of abdominal muscles: the effect on pulmonary function in patients with tetraplegia. Spinal Cord. 2007; 45(7):491-5. DOI: 10.1038/sj.sc.3102039. View

18.

DiMarco A, Romaniuk J, Kowalski K, Supinski G . Mechanical contribution of expiratory muscles to pressure generation during spinal cord stimulation. J Appl Physiol (1985). 1999; 87(4):1433-9. DOI: 10.1152/jappl.1999.87.4.1433. View

19.

DiMarco A, Kowalski K, Geertman R, Hromyak D . Lower thoracic spinal cord stimulation to restore cough in patients with spinal cord injury: results of a National Institutes of Health-sponsored clinical trial. Part I: methodology and effectiveness of expiratory muscle activation. Arch Phys Med Rehabil. 2009; 90(5):717-25. PMC: 2813808. DOI: 10.1016/j.apmr.2008.11.013. View

20.

LOUDON R, Shaw G . Mechanics of cough in normal subjects and in patients with obstructive respiratory disease. Am Rev Respir Dis. 1967; 96(4):666-77. DOI: 10.1164/arrd.1967.96.4.666. View