Krzysztof E Kowalski1, Anthony F DiMarco2. 1. Department of Physical Medicine and Rehabilitation, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, USA; MetroHealth Research Institute, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, USA. Electronic address: kek5@case.edu. 2. Department of Physical Medicine and Rehabilitation, Case Western Reserve University, 2500 MetroHealth Drive, Cleveland, OH, USA; MetroHealth Research Institute, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH, USA. Electronic address: afd3@case.edu.
Abstract
OBJECTIVE: To compare the effectiveness of wire versus disc electrodes to activate the inspiratory muscles via high frequency spinal cord stimulation. DESIGN: Animal study. SETTING: Research laboratory. ANIMALS: Dogs (n = 5) INTERVENTIONS: In separate trials, spinal cord stimulation (SCS) was applied via disc (DE) and two parallel wire electrodes (WE) on the ventral epidural space at the T2-T3 spinal region. MAIN OUTCOME MEASURE(S): Airway pressure (P) and inspired volume (V) generation following stimulation with DE and WE were compared. Given our previous success with (DE), outcome variables with this electrode were used as our gold standard to which all comparisons were made. RESULTS: Two configurations of WE using monopolar stimulation (MS) resulted in P and V that were similar to those generated with MS with DE. For example, MS with parallel WE connected together to function as a common cathode (Y-connection) and a 2-channel system (separate cathodes with a remote ground), resulted in P that were 91 ± 6 and 92 ± 4%, respectively, of those achieved with DE (NS for both). Bipolar stimulation with parallel WE using a Y-connection and with a 2-channel system, resulted in P that were 96 ± 4 and 94 ± 4%, of the P achieved with DE (NS for both). CONCLUSION(S): These results suggest that specific configurations of WE, which can be placed via minimally invasive techniques, provide comparable activation of the inspiratory muscles compared to DE and may be a useful technique to restore ventilatory support in persons with spinal cord injury.
OBJECTIVE: To compare the effectiveness of wire versus disc electrodes to activate the inspiratory muscles via high frequency spinal cord stimulation. DESIGN: Animal study. SETTING: Research laboratory. ANIMALS: Dogs (n = 5) INTERVENTIONS: In separate trials, spinal cord stimulation (SCS) was applied via disc (DE) and two parallel wire electrodes (WE) on the ventral epidural space at the T2-T3 spinal region. MAIN OUTCOME MEASURE(S): Airway pressure (P) and inspired volume (V) generation following stimulation with DE and WE were compared. Given our previous success with (DE), outcome variables with this electrode were used as our gold standard to which all comparisons were made. RESULTS: Two configurations of WE using monopolar stimulation (MS) resulted in P and V that were similar to those generated with MS with DE. For example, MS with parallel WE connected together to function as a common cathode (Y-connection) and a 2-channel system (separate cathodes with a remote ground), resulted in P that were 91 ± 6 and 92 ± 4%, respectively, of those achieved with DE (NS for both). Bipolar stimulation with parallel WE using a Y-connection and with a 2-channel system, resulted in P that were 96 ± 4 and 94 ± 4%, of the P achieved with DE (NS for both). CONCLUSION(S): These results suggest that specific configurations of WE, which can be placed via minimally invasive techniques, provide comparable activation of the inspiratory muscles compared to DE and may be a useful technique to restore ventilatory support in persons with spinal cord injury.