{Reference Type}: Journal Article
{Title}: Closed-loop cervical epidural stimulation partially restores ipsilesional diaphragm EMG after acute C2 hemisection.
{Author}: Mickle AR;Peñaloza-Aponte JD;Coffey R;Hall NA;Baekey D;Dale EA;
{Journal}: Respir Physiol Neurobiol
{Volume}: 320
{Issue}: 0
{Year}: 2024 Feb 1
{Factor}: 2.821
{DOI}: 10.1016/j.resp.2023.104182
{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.