HCR.20.030 – Neurally controlled diaphragm pacing

The diaphragm is our most important breathing muscle. Paralysis or weakness of the diaphragm is a cardinal feature in many neuromuscular diseases, leading to suffocation or necessitating life-long mechanical ventilation. The latter severely impairs mobility and independency of these patients. In spite its importance, therapies for diaphragm weakness are limited. In analogy to cardiac pacemakers, pacing of the diaphragm is available. However, currently available diaphragm pacemaker technology is rudimentary with a fixed respiratory rate and magnitude, and is isolated from the patient’s individual physiological needs. Therefore, pacing is only applicable in the few patients with complete loss of diaphragm function. However, the majority of patients with neuromuscular disorders, such as ALS, have partial loss of diaphragm function. It is hypothesized that asynchrony between the patient’s respiratory demands and the diaphragm pacemaker limits effective breathing and may even be harmful. To overcome these limitations, a closed-loop approach is required that interacts with the patient’s individual physiological needs. Therefore, in this project we will develop novel closed-loop diaphragm pacemaker technology that is controlled by the patient’s intrinsic neural respiratory demands. Ultimately this project aims to restore breathing and improve independency and mobility of patients with diaphragm weakness.

Keywords

breathing, closed-loop, diaphragm, neurostimulation, pacemaker

Other organisations

IMDI NeuroControl