BIOTECHNOLOGY Invention aims to help paralyzed people to breathe easy

The experimental device is designed to return the user's ability to cough.
CLEVELAND (AP) -- A doctor who helped develop a device to allow Christopher Reeve to breathe unassisted used similar technology in a bid to help another paralyzed man regain the ability to cough and clear his lungs.
Dr. Anthony DiMarco, a research scientist at MetroHealth Medical Center and professor of physiology and biophysics at Case Western Reserve University, implanted three electrodes in the patient's spinal cord on June 23.
Ronnie Moore, 52, of Madison, northeast of Cleveland, was paralyzed from the neck down in a 1998 car accident. He's the first patient to participate in a four-year, $1.5 million study paid for by the National Institutes of Health.
Like about 40 percent of the 250,000 Americans with traumatic spinal cord injuries, Moore is unable to cough, making him susceptible to respiratory infections like bronchitis and pneumonia -- a leading cause of death in paraplegics and quadriplegics.
"Most of us take for granted that we can just clear our throats or cough something up. Patients [with spinal cord injuries] can't do that, and it's an emergency situation for them," Dr. DiMarco said.
Dr. DiMarco is experimenting with an external electrical device that for years has been used to stimulate muscles that control bladder function in paralyzed people.
How it works
With approval from the Food and Drug Administration, Dr. DiMarco will see if the device's electrodes can contract the abdominal muscles and, in theory, generate a cough.
Dr. William S. Pease, chairman of physical medicine and rehabilitation at the Ohio State University Medical Center, said Thursday the experiment could provide great benefit to pneumonia-prone quadriplegics.
"This is a very nice application of technology to real life-and-death issues," he said.
Dr. Pease said the risks include possible surgical complications such as infection and bleeding. Because the electrodes are placed in a paralyzed spinal area, the risk of the electrode causing further spinal damage would be minimized, he said.
Naomi Kleitman, a researcher at the NIH's National Institute of Neurological Disorders and Stroke, said the experiment reflected an innovative use of existing technology.
"This is a really good example where animal studies, previous clinical experiments and a critical need for the spinal-cord population are all coming together now in a bench-to-bedside application," Kleitman said.
Testing effectiveness
Dr. DiMarco tested the device with a low dose of electricity shortly after implanting the electrodes in Moore's spine. Moore's abdomen twitched.
Because Moore can move his right arm slightly, he will be able to trigger the device by pushing a pillow-like button strapped to the arm of his wheelchair.
Dr. DiMarco won't know if the device is successful at restoring Moore's ability to cough for at least one month. Moore's muscles have weakened, and they must regain their strength.
Moore can breathe on his own but he hasn't been able to clear his throat or cough. Some nights, he wakes up panicked, gasping for air, the fluid in his throat making gurgling sounds.
"It's a terrifying feeling," Moore said.
Dr. DiMarco hopes to include 18 other patients in his study.

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