PDF(Pubmed)
Abstract：
Cervical spinal cord injury creates lasting respiratory deficits which can require mechanical ventilation long-term. We have shown that closed-loop epidural stimulation (CL-ES) elicits respiratory plasticity in the form of increased phrenic network excitability (Malone et. al., E Neuro, Vol 9, 0426-21.2021, 2022); however, the ability of this treatment to create functional benefits for breathing function per se after injury has not been demonstrated. Here, we demonstrate in C2 hemisected anesthetized rats, a 20-minute bout of CL-ES administered at current amplitudes below the motor threshold restores paralyzed hemidiaphragm activity in-phase with breathing while potentiating contralesional activity. While this acute bout of stimulation did not elicit the increased network excitability seen in our chronic model, a subset of stimulated animals continued spontaneous ipsilesional diaphragm activity for several seconds after stopping stimulation. These results support the use of CL-ES as a therapeutic to rescue breathing after high cervical spinal cord injury, with the potential to lead to lasting recovery and device independence.
摘要：
颈脊髓损伤会造成持久的呼吸障碍，这可能需要长期的机械通气。我们已经证明，闭环硬膜外刺激（CL-ES）以增加的膈网络兴奋性的形式引起呼吸可塑性（Malone等。Al.,E神经,第9卷，0426-21.2021,2022)；然而，这种治疗对损伤后呼吸功能本身产生功能益处的能力尚未得到证实.这里,我们在C2半切麻醉大鼠中证明，以低于运动阈值的电流幅度给药20分钟的CL-ES恢复了与呼吸同相的麻痹的半膈活动，同时增强了对侧活动。虽然这种急性刺激并没有引起我们慢性模型中网络兴奋性的增加，一部分受刺激的动物在停止刺激后持续自发的横膈活动几秒钟。这些结果支持使用CL-ES作为高颈脊髓损伤后抢救呼吸的治疗方法，有可能导致持久的恢复和设备独立。
