Edited from Scientific Reports
Lower urinary tract (LUT) dysfunction is one of the primary concerns of people living with spinal cord injury (SCI), as it is one of the principal causes of re-hospitalization after SCI and a major source of morbidity and mortality. After SCI, neurogenic bladder develops, characterized by storage and voiding dysfunction with detrusor sphincter dyssynergia (DSD) as the most significant source of LUT complications. DSD is when bladder contractions are coincident with urethral sphincter contractions, causing the pressure inside the LUT to rise to unsafe levels. Chronic elevation of vesical pressure can lead to LUT and kidney damage.
More recent pre-clinical and clinical scES experiments directly targeting the thoracolumbar and lumbosacral circuitries mediating LUT function have shown improvements in storage, detrusor pressure, and emptying. However, although targeting L6/S1 (parasympathetic level) and T13/L1 (sympathetic level) via scES in the urethane-anesthetized SCI rodent model during cystometry can lead to changes in inter-contractile interval (ICI; time between two voids) and detrusor activation, it does not alter the incidence of DSD. The lack of coordination between the external urethral sphincter (EUS) and detrusor muscle, resulting in low-volume voids, high bladder pressure, and an increased risk of autonomic dysreflexia, may need to be ameliorated by targeting the bladder and EUS circuitries with scES simultaneously. Experimental data supports the existence of a lumbar spinal coordinating center (LSCC) at L3 in rats that modulates EUS activation during micturition. The LSCC has projections to both L6/S1 and T13/L1 to coordinate activation of the EUS and detrusor. In the current pre-clinical study, the L3 was targeted with scES to examine whether the EUS could be modulated under intact and chronic complete SCI conditions.
This journal was authored by:
- Daniel Medina-Aguiñaga
- Robert F. Hoey
- Natasha L. Wilkins
- Beatrice Ugiliweneza
- Jason Fell
- Susan J. Harkema
- Charles H. Hubscher
Read the entire Published Journal in Scientific Reports
