Ovechkin Alexander, Moshonkina Tatiana, Shandybina Natalia, Lyakhovetskii Vsevolod, Gorodnichev Ruslan, Moiseev Sergey, Siu Ricardo, Gerasimenko Yury
Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA.
Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA.
Life (Basel). 2023 Jul 14;13(7):1563. doi: 10.3390/life13071563.
A growing number of studies have reported Coronavirus disease (COVID-19) related to both respiratory and central nervous system dysfunctions. This study evaluates the neuromodulatory effects of spinal cord transcutaneous stimulation (scTS) on the respiratory functional state in healthy controls and patients with post-COVID-19 respiratory deficits as a step toward the development of a rehabilitation strategy for these patients.
In this before-after, interventional, case-controlled clinical study, ten individuals with post-acute COVID-19 respiratory deficits and eight healthy controls received a single twenty-minute-long session of modulated monophasic scTS delivered over the T5 and T10 spinal cord segments. Forced vital capacity (FVC), peak forced inspiratory flow (PIF), peak expiratory flow (PEF), time-to-peak of inspiratory flow (tPIF), and time-to-peak of expiratory flow (tPEF), as indirect measures of spinal motor network activity, were assessed before and after the intervention.
In the COVID-19 group, the scTS intervention led to significantly increased PIF ( = 0.040) and PEF ( = 0.049) in association with significantly decreased tPIF ( = 0.035) and tPEF ( = 0.013). In the control group, the exposure to scTS also resulted in significantly increased PIF ( = 0.010) and significantly decreased tPIF ( = 0.031). Unlike the results in the COVID-19 group, the control group had significantly decreased PEF ( = 0.028) associated with significantly increased tPEF ( = 0.036). There were no changes for FVC after scTS in both groups ( = 0.67 and = 0.503).
In post-COVID-19 patients, scTS facilitates excitation of both inspiratory and expiratory spinal neural networks leading to an immediate improvement of respiratory functional performance. This neuromodulation approach could be utilized in rehabilitation programs for patients with COVID-19 respiratory deficits.
越来越多的研究报告了与冠状病毒病（COVID-19）相关的呼吸和中枢神经系统功能障碍。本研究评估脊髓经皮刺激（scTS）对健康对照者和COVID-19后呼吸功能障碍患者呼吸功能状态的神经调节作用，作为为这些患者制定康复策略的第一步。
在这项前后对照、干预性、病例对照临床研究中，10名急性COVID-19后呼吸功能障碍患者和8名健康对照者接受了一次时长20分钟、在T5和T10脊髓节段进行的调制单相scTS治疗。作为脊髓运动网络活动的间接指标，在干预前后评估用力肺活量（FVC）、用力吸气峰值流速（PIF）、呼气峰值流速（PEF）、吸气流速峰值时间（tPIF）和呼气流速峰值时间（tPEF）。
在COVID-19组中，scTS干预导致PIF显著增加（P = 0.040）和PEF显著增加（P = 0.049），同时tPIF显著降低（P = 0.035）和tPEF显著降低（P = 0.013）。在对照组中，接受scTS治疗也导致PIF显著增加（P = 0.010）和tPIF显著降低（P = 0.031）。与COVID-19组的结果不同，对照组的PEF显著降低（P = 0.028），同时tPEF显著增加（P = 0.036）。两组scTS治疗后FVC均无变化（P = 分别为0.67和0.503）。
在COVID-19后患者中，scTS促进吸气和呼气脊髓神经网络的兴奋，从而立即改善呼吸功能表现。这种神经调节方法可用于COVID-19呼吸功能障碍患者的康复计划。
