%0 Journal Article
%T Closed-loop cervical epidural stimulation partially restores ipsilesional diaphragm EMG after acute C2 hemisection.
%A Mickle AR
%A Peñaloza-Aponte JD
%A Coffey R
%A Hall NA
%A Baekey D
%A Dale EA
%J Respir Physiol Neurobiol
%V 320
%N 0
%D 2024 Feb 1
%M 37923238
%F 2.821
%R 10.1016/j.resp.2023.104182
%X 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.