Kowalski, Krzysztof E, PhD

Dr. Krzysztof E. Kowalski is a neurophysiologist and clinical scientist with over three decades of experience in motor control and the restoration of respiratory muscle function in persons with spinal cord injury. He has been an investigator at the Cleveland FES Center since 2009.

He is recognized for a series of landmark contributions to respiratory neuroprosthetics, including the first demonstration that intercostal muscles could be electrically stimulated and paced to provide artificial ventilation, the first clinical application of intramuscular diaphragm electrodes placed via laparoscopy and the development of spinal cord stimulation to restore an effective cough mechanism, successfully applied in 29 subjects to date. He is a two-time winner of the NIH SPARC Neuromod Prize.

Dr. Kowalski currently serves as leading co-investigator on this novel method of inspiratory muscle pacing using high-frequency spinal cord stimulation applied to the upper thoracic spinal cord — a technique that, in contrast to all prior pacing methods, results in physiologic, synchronous activation of both the diaphragm and inspiratory intercostal muscles.

The purpose of this work is to restore respiratory muscle function in patients with spinal cord injury. The team is developing systems for electrical activation of the inspiratory muscles to maintain full-time ventilatory support in patients with ventilator-dependent tetraplegia and electrical activation of the expiratory muscles to provide an effective cough mechanism in patients with expiratory muscles paralysis. Ventilatory support systems decrease the cost of medical care, improve speech, increase patient comfort, increase the ease of transportation and, overall improve life quality. Restoration of an effective cough mechanism has the potential to significantly decrease the risk of respiratory complications, which still account for most of the morbidity and mortality in traumatic tetraplegia.

RESEARCH PROGRAMS

Restoration of respiratory muscle function in subjects with spinal cord injury:

• Electrical stimulation for restoration of cough in tetraplegic subjects
• High Frequency Spinal Cord Stimulation (HF-SCS) to restore inspiratory muscle function in spinal cord injury
• Combined intercostal and diaphragm pacing for artificial ventilation in tetraplegia
• Intramuscular diaphragm electrode pacing via laparoscopic surgery
• Bowel management via lower thoracic spinal cord stimulation in SCI

MAJOR PROJECTS & FUNDING

• NIH-Funded Research, co-investigator on spinal cord stimulation to restore an effective cough mechanism; successfully applied in 29 subjects with dramatic improvements in quality of life and significant reduction in respiratory infections
• FDA-Funded Research, first to wean several patients off mechanical ventilation using combined intercostal and unilateral diaphragm pacing; technique now commercially available worldwide in 1,400+ patients
• High-frequency spinal cord stimulation for inspiratory pacing — leading co-investigator on novel method producing physiologic, synchronous diaphragm and intercostal activation in pre-clinical and clinical models
• Lower thoracic spinal cord stimulation — co-investigator on studies demonstrating effects on bowel management in SCI subjects

HONORS & RECOGNITION

• NIH SPARC Neuromod Prize — Phase 2 Winner, 2024
• NIH SPARC Neuromod Prize — Phase 1 Winner, 2022
• VA Research Day on the Hill — 25 Leading VA Researchers, Department of Veterans Affairs, 2019
• Best Empirical Research Poster Award, Academy of Spinal Cord Injury Professionals, 2018
• Award of Excellence, Academy of Spinal Cord Injury Professionals, 2016
• Best Poster Award, Academy of Spinal Cord Injury Professionals, 2015
• Chair Award for Contribution in Research, MetroHealth Medical Center / Case Western Reserve University, 2014
• Award for Best Empirical Research, Academy of Spinal Cord Injury Professionals, 2013
• The Apple Award, Co-author, Best Published Research Article in Spinal Cord Injury Medicine, American Spinal Injury Association, 2009
• Top 5 Highest Ranking Posters Recognition, American Paraplegia Society, 2005