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Volume 14
Issue 11
10.3390/jcm14113827
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Mechanism-Based Neuromodulation in Augmenting Respiratory Motor Function in Individuals with Spinal Cord Injury

by
Farwah Fatima
1,†,
Niraj Singh Tharu
1,*,†,
Camilo Castillo
2,
Alex Ng
3,
Yury Gerasimenko
4 and
Alexander Ovechkin
1,5
1
Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA
2
Department of Neurological Surgery, Division of Physical Medicine and Rehabilitation, University of Louisville, Louisville, KY 40202, USA
3
Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Disorders Medicine, University of Louisville, Louisville, KY 40202, USA
4
Department of Physiology, University of Louisville, Louisville, KY 40202, USA
5
Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Clin. Med. 2025, 14(11), 3827; https://doi.org/10.3390/jcm14113827
Submission received: 9 April 2025 / Revised: 23 May 2025 / Accepted: 27 May 2025 / Published: 29 May 2025
(This article belongs to the Section Clinical Neurology)
Versions Notes

Abstract

Spinal cord injury (SCI) is one of the most debilitating conditions that has profound effects on every physiological system, including respiratory dysfunction, which is listed among the most common causes of mortality and morbidity in this population. Previous research has demonstrated that respiratory training could facilitate respiratory motor- and autonomic activity-based plasticity. However, due to the reduced excitability of spinal networks below the level of injury, the effectiveness of such interventions is often limited to the residual functional capacity preserved after injury. In recent decades, several novel neuromodulatory techniques have been explored to enhance neuronal connectivity and integrate into respiratory rehabilitation strategies. In this review, we examine the mechanisms underlying respiratory deficits following SCI and discuss the neuromodulatory approaches designed to promote neural plasticity for respiratory recovery. Current evidence suggests that integrating multimodal neuromodulation with activity-based respiratory training holds promise; it may significantly enhance respiratory functional recovery and could become a standard component of respiratory rehabilitation protocols in individuals with SCI.
Keywords: neuromodulation; rehabilitation; respiratory motor function; spinal cord stimulation; respiratory muscles; respiratory muscle training; spinal excitability; neuronal plasticity; spinal cord injury neuromodulation; rehabilitation; respiratory motor function; spinal cord stimulation; respiratory muscles; respiratory muscle training; spinal excitability; neuronal plasticity; spinal cord injury

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MDPI and ACS Style

Fatima, F.; Tharu, N.S.; Castillo, C.; Ng, A.; Gerasimenko, Y.; Ovechkin, A. Mechanism-Based Neuromodulation in Augmenting Respiratory Motor Function in Individuals with Spinal Cord Injury. J. Clin. Med. 2025, 14, 3827. https://doi.org/10.3390/jcm14113827

AMA Style

Fatima F, Tharu NS, Castillo C, Ng A, Gerasimenko Y, Ovechkin A. Mechanism-Based Neuromodulation in Augmenting Respiratory Motor Function in Individuals with Spinal Cord Injury. Journal of Clinical Medicine. 2025; 14(11):3827. https://doi.org/10.3390/jcm14113827

Chicago/Turabian Style

Fatima, Farwah, Niraj Singh Tharu, Camilo Castillo, Alex Ng, Yury Gerasimenko, and Alexander Ovechkin. 2025. "Mechanism-Based Neuromodulation in Augmenting Respiratory Motor Function in Individuals with Spinal Cord Injury" Journal of Clinical Medicine 14, no. 11: 3827. https://doi.org/10.3390/jcm14113827

APA Style

Fatima, F., Tharu, N. S., Castillo, C., Ng, A., Gerasimenko, Y., & Ovechkin, A. (2025). Mechanism-Based Neuromodulation in Augmenting Respiratory Motor Function in Individuals with Spinal Cord Injury. Journal of Clinical Medicine, 14(11), 3827. https://doi.org/10.3390/jcm14113827

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