PMID- 35778466
OWN - NLM
STAT- MEDLINE
DCOM- 20220707
LR  - 20220909
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 12
IP  - 1
DP  - 2022 Jul 1
TI  - Targeting bladder function with network-specific epidural stimulation after 
      chronic spinal cord injury.
PG  - 11179
LID - 10.1038/s41598-022-15315-2 [doi]
LID - 11179
AB  - Profound dysfunctional reorganization of spinal networks and extensive loss of 
      functional continuity after spinal cord injury (SCI) has not precluded 
      individuals from achieving coordinated voluntary activity and gaining 
      multi-systemic autonomic control. Bladder function is enhanced by approaches, 
      such as spinal cord epidural stimulation (scES) that modulates and strengthens 
      spared circuitry, even in cases of clinically complete SCI. It is unknown whether 
      scES parameters specifically configured for modulating the activity of the lower 
      urinary tract (LUT) could improve both bladder storage and emptying. Functional 
      bladder mapping studies, conducted during filling cystometry, identified specific 
      scES parameters that improved bladder compliance, while maintaining stable blood 
      pressure, and enabled the initiation of voiding in seven individuals with motor 
      complete SCI. Using high-resolution magnetic resonance imaging and finite element 
      modeling, specific neuroanatomical structures responsible for modulating bladder 
      function were identified and plotted as heat maps. Data from this pilot clinical 
      trial indicate that scES neuromodulation that targets bladder compliance reduces 
      incidences of urinary incontinence and provides a means for mitigating autonomic 
      dysreflexia associated with bladder distention. The ability to initiate voiding 
      with targeted scES is a key step towards regaining volitional control of LUT 
      function, advancing the application and adaptability of scES for autonomic 
      function.
CI  - (c) 2022. The Author(s).
FAU - Herrity, April N
AU  - Herrity AN
AD  - Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, 
      The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, 
      KY, 40202, USA. april.herrity@louisville.edu.
AD  - Department of Neurological Surgery, University of Louisville, Louisville, KY, 
      USA. april.herrity@louisville.edu.
AD  - Department of Physiology, University of Louisville, Louisville, KY, USA. 
      april.herrity@louisville.edu.
FAU - Aslan, Sevda C
AU  - Aslan SC
AD  - Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, 
      The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, 
      KY, 40202, USA.
AD  - Department of Neurological Surgery, University of Louisville, Louisville, KY, 
      USA.
FAU - Mesbah, Samineh
AU  - Mesbah S
AD  - Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, 
      The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, 
      KY, 40202, USA.
AD  - Department of Neurological Surgery, University of Louisville, Louisville, KY, 
      USA.
FAU - Siu, Ricardo
AU  - Siu R
AD  - Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, 
      The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, 
      KY, 40202, USA.
AD  - Department of Neurological Surgery, University of Louisville, Louisville, KY, 
      USA.
FAU - Kalvakuri, Karthik
AU  - Kalvakuri K
AD  - Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, 
      The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, 
      KY, 40202, USA.
FAU - Ugiliweneza, Beatrice
AU  - Ugiliweneza B
AD  - Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, 
      The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, 
      KY, 40202, USA.
AD  - Department of Neurological Surgery, University of Louisville, Louisville, KY, 
      USA.
AD  - Department of Health Sciences, University of Louisville, Louisville, KY, USA.
FAU - Mohamed, Ahmad
AU  - Mohamed A
AD  - Department of Urology, University of Louisville, Louisville, KY, USA.
FAU - Hubscher, Charles H
AU  - Hubscher CH
AD  - Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, 
      The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, 
      KY, 40202, USA.
AD  - Department of Anatomical Sciences and Neurobiology, University of Louisville, 
      Louisville, KY, USA.
FAU - Harkema, Susan J
AU  - Harkema SJ
AD  - Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, 
      The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, 
      KY, 40202, USA.
AD  - Department of Neurological Surgery, University of Louisville, Louisville, KY, 
      USA.
LA  - eng
GR  - SPARC Common Fund OT2OD024898/NH/NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20220701
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
SB  - IM
MH  - Epidural Space
MH  - Humans
MH  - *Spinal Cord Injuries
MH  - *Spinal Cord Stimulation/methods
MH  - Urinary Bladder
MH  - Urination
PMC - PMC9249897
COIS- The authors declare no competing interests.
EDAT- 2022/07/02 06:00
MHDA- 2022/07/08 06:00
PMCR- 2022/07/01
CRDT- 2022/07/01 23:21
PHST- 2022/01/24 00:00 [received]
PHST- 2022/06/22 00:00 [accepted]
PHST- 2022/07/01 23:21 [entrez]
PHST- 2022/07/02 06:00 [pubmed]
PHST- 2022/07/08 06:00 [medline]
PHST- 2022/07/01 00:00 [pmc-release]
AID - 10.1038/s41598-022-15315-2 [pii]
AID - 15315 [pii]
AID - 10.1038/s41598-022-15315-2 [doi]
PST - epublish
SO  - Sci Rep. 2022 Jul 1;12(1):11179. doi: 10.1038/s41598-022-15315-2.