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Electrical Neuromodulation of the Respiratory System After Spinal Cord Injury.

Authors
  • Hachmann, Jan T1
  • Grahn, Peter J1
  • Calvert, Jonathan S2
  • Drubach, Dina I1
  • Lee, Kendall H3
  • Lavrov, Igor A4
  • 1 Department of Neurologic Surgery, Mayo Clinic, Rochester, MN.
  • 2 Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN.
  • 3 Department of Neurologic Surgery, Mayo Clinic, Rochester, MN; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN; Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.
  • 4 Department of Neurologic Surgery, Mayo Clinic, Rochester, MN. Electronic address: [email protected]
Type
Published Article
Journal
Mayo Clinic Proceedings
Publisher
Elsevier
Publication Date
Sep 01, 2017
Volume
92
Issue
9
Pages
1401–1414
Identifiers
DOI: 10.1016/j.mayocp.2017.04.011
PMID: 28781176
Source
Medline
License
Unknown

Abstract

Spinal cord injury (SCI) is a complex and devastating condition characterized by disruption of descending, ascending, and intrinsic spinal circuitry resulting in chronic neurologic deficits. In addition to limb and trunk sensorimotor deficits, SCI can impair autonomic neurocircuitry such as the motor networks that support respiration and cough. High cervical SCI can cause complete respiratory paralysis, and even lower cervical or thoracic lesions commonly result in partial respiratory impairment. Although electrophrenic respiration can restore ventilator-independent breathing in select candidates, only a small subset of affected individuals can benefit from this technology at this moment. Over the past decades, spinal cord stimulation has shown promise for augmentation and recovery of neurologic function including motor control, cough, and breathing. The present review discusses the challenges and potentials of spinal cord stimulation for restoring respiratory function by overcoming some of the limitations of conventional respiratory functional electrical stimulation systems.

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