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首页> 美国卫生研究院文献>Journal of Neurophysiology >Spinal Control of Motor Outputs: High-frequency epidural stimulation across the respiratory cycle evokes phrenic short-term potentiation after incomplete cervical spinal cord injury
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Spinal Control of Motor Outputs: High-frequency epidural stimulation across the respiratory cycle evokes phrenic short-term potentiation after incomplete cervical spinal cord injury

机译：脊髓运动控制输出：整个呼吸周期的高频硬膜外刺激在颈髓脊髓损伤不完全后引起短期增强作用

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C2 spinal hemilesion (C2Hx) paralyzes the ipsilateral diaphragm, but recovery is possible through activation of “crossed spinal” synaptic inputs to ipsilateral phrenic motoneurons. We tested the hypothesis that high-frequency epidural stimulation (HF-ES) would potentiate ipsilateral phrenic output after subacute and chronic C2Hx. HF-ES (300 Hz) was applied to the ventrolateral C4 or T2 spinal cord ipsilateral to C2Hx in anesthetized and mechanically ventilated adult rats. Stimulus duration was 60 s, and currents ranged from 100 to 1,000 µA. Bilateral phrenic nerve activity and ipsilateral hypoglossal (XII) nerve activity were recorded before and after HF-ES. Higher T2 stimulus currents potentiated ipsilateral phasic inspiratory activity at both 2 and 12 wk post-C2Hx, whereas higher stimulus currents delivered at C4 potentiated ipsilateral phasic phrenic activity only at 12 wk (P = 0.028). Meanwhile, tonic output in the ipsilateral phrenic nerve reached 500% of baseline values at the high currents with no difference between 2 and 12 wk. HF-ES did not trigger inspiratory burst-frequency changes. Similar responses occurred following T2 HF-ES. Increases in contralateral phrenic and XII nerve output were induced by C4 and T2 HF-ES at higher currents, but the relative magnitude of these changes was small compared with the ipsilateral phrenic response. We conclude that following incomplete cervical spinal cord injury, HF-ES of the ventrolateral midcervical or thoracic spinal cord can potentiate efferent phrenic motor output with little impact on inspiratory burst frequency. However, the substantial increases in tonic output indicate that the uninterrupted 60-s stimulation paradigm used is unlikely to be useful for respiratory muscle activation after spinal injury.>NEW & NOTEWORTHY Previous studies reported that high-frequency epidural stimulation (HF-ES) activates the diaphragm following acute spinal transection. This study examined HF-ES and phrenic motor output following subacute and chronic incomplete cervical spinal cord injury. Short-term potentiation of phrenic bursting following HF-ES illustrates the potential for spinal stimulation to induce respiratory neuroplasticity. Increased tonic phrenic output indicates that alternatives to the continuous stimulation paradigm used in this study will be required for respiratory muscle activation after spinal cord injury.
机译：C2脊柱上裂（C2Hx）使同侧隔膜瘫痪，但是可以通过激活“交叉脊柱”突触输入到同侧运动神经元来恢复。我们检验了以下假设，即高频硬膜外刺激（HF-ES）在亚急性和慢性C2Hx后会增强同侧输出。在麻醉和机械通气的成年大鼠中，将HF-ES（300 Hz）应用于C2Hx同侧的腹侧C4或T2脊髓。刺激持续时间为60 s，电流范围为100至1,000 µA。在HF-ES之前和之后记录双侧神经活动和同侧舌下神经（XII）神经活动。较高的T2刺激电流在C2Hx后2周和12周均增强了同侧相吸气活动，而较高的刺激电流仅在12周时在C4处增强了同侧相活动（P = 0.028）。同时，在高电流下，同侧神经的补品输出达到基线值的500％，2周和12周之间无差异。 HF-ES不会触发吸气突发频率变化。 T2 HF-ES后发生类似的反应。 C4和T2 HF-ES在较高电流下引起对侧和XII神经输出的增加，但与同侧反应相比，这些变化的相对幅度较小。我们得出结论，在颈髓脊髓损伤不完全之后，腹侧中颈或胸脊髓的HF-ES可以增强传出的运动输出，而对吸气爆发频率几乎没有影响。但是，补品输出的大量增加表明，使用不间断的60 s刺激范例不太可能对脊髓损伤后的呼吸肌激活有用。> NEW＆NOTEWORTHY 先前的研究报道，高频硬膜外刺激（HF-ES）在急性脊髓横断后激活the肌。这项研究检查了亚急性和慢性不完全性颈脊髓损伤后的HF-ES和运动输出。 HF-ES后声爆发的短期增强说明了脊髓刺激诱发呼吸性神经可塑性的潜力。 to气输出增加表明，脊髓损伤后呼吸肌激活需要替代本研究中使用的连续刺激范例。

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