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Epidural Stimulation Targeting Lower Urinary Tract Function in Spinally Intact and Transected Urethane‐Anesthetized Rats
Author(s) -
Hubscher Charles,
Hoey Robert,
Medina-Aguinaga Daniel,
Khalifa Fahmi,
Zdunowski Sharon,
El-Baz Ayman,
Herrity April,
Harkema Susan
Publication year - 2020
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2020.34.s1.06023
Subject(s) - spinal cord injury , cystometry , medicine , stimulation , anesthesia , urinary system , spinal cord , urethral sphincter , urinary bladder , urology , urinary incontinence , psychiatry
Bladder management for conditions such as spinal cord injury (SCI) includes a combination of catheterization (either self‐intermittent or suprapubic) and pharmacological approaches, which targets maintenance but does not promote recovery of function. We have exciting data from multiple individuals receiving spinal cord epidural stimulation (scES) that is optimized for stepping and standing, in combination with task‐specific training, that shows improvements in lower urinary tract function. The objective of our current functional mapping pre‐clinical animal studies is to identify scES configurations (electrode location, amplitude and frequency) that can promote optimal neural control of urine storage (adequate bladder capacity at safe pressures without incontinence) and sufficient controlled emptying (high voiding efficiency at safe leak point pressures). Initial mapping was done in acute anesthetized terminal preparations during cystometry (bladder filling) using a modified Medtronic Specify 5‐6‐5 epidural array that is being used by our group in parallel human scES studies. The current data compares the response to scES in spinally intact and transected male and female rats 6 weeks post‐injury at T13‐L1 (level of sympathetic supply), L3‐4 (region with circuits related to external urethral sphincter control) and L6‐S1 (level of parasympathetic supply) spinal segments. Results indicate that scES storage effects and voiding efficiency were dependent upon presence/absence of spinal transection, frequency and intensity stimulation patterns, electrode location, and sex of the animals. Taken together these results suggest that the circuitry is dissociable and amenable to stimulation that seeks to promote either storage or voiding. Furthermore, our innovative approach and novel application of this Medtronic Specify 5‐6‐5 epidural device will generate functional maps that will lay the groundwork for expedient translation of this promising technology to individuals with SCI as well as provide a powerful tool for elucidating underlying circuits present in the lumbosacral cord that are involved in urogenital function. Support or Funding Information NIH SPARC OT2OD024898