Boggs Joseph W, Wenzel Brian J, Gustafson Kenneth J, Grill Warren M
Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
J Physiol. 2006 Nov 15;577(Pt 1):115-26. doi: 10.1113/jphysiol.2006.111815. Epub 2006 Aug 31.
Activation of urethral or genital afferents of the pudendal nerve can elicit or inhibit micturition, and low frequency stimulation of the compound pudendal nerve (PN) is known to produce a continence response. The present study demonstrates that PN stimulation also can elicit a micturition-like response and that the response to PN stimulation is dependent on stimulation frequency. We measured the changes in bladder pressure and external urethral sphincter (EUS) electroneurogram (ENG) evoked by PN stimulation before and up to 16 h after spinal cord transection (SCT) in cats anaesthetized with alpha-chloralose. Low frequency (10 Hz) stimulation elicited a continence-like response, including inhibition of the bladder and activation of the EUS, but mid-frequency (33 Hz) stimulation produced a micturition-like response, including excitation of the bladder without activation of the EUS. The dependence of the response on stimulus frequency was linked to interpulse interval as the same number of pulses at 10, 33 and 100 Hz produced different responses. Stimulation of the PN at 33 Hz produced bladder contractions before and 8 h after SCT provided the bladder contained a minimum volume of fluid. Only mid-range frequency stimulation with sufficient stimulus train duration produced a reduction in EUS ENG activity before and after SCT. In addition to a continence-like response, PN stimulation can also elicit a micturition-like response, and this response is dependent on stimulation frequency, stimulus train duration, and bladder volume. The ability to control the two principal functions of the bladder by pudendal nerve stimulation is an exciting prospect for neurorehabilitation.
阴部神经的尿道或生殖器传入神经的激活可引发或抑制排尿，并且已知对阴部复合神经（PN）的低频刺激会产生控尿反应。本研究表明，PN刺激也可引发类似排尿的反应，并且对PN刺激的反应取决于刺激频率。我们测量了在用α-氯醛糖麻醉的猫脊髓横断（SCT）前及术后长达16小时，PN刺激诱发的膀胱压力和尿道外括约肌（EUS）肌电图（ENG）的变化。低频（10Hz）刺激引发类似控尿的反应，包括膀胱抑制和EUS激活，但中频（33Hz）刺激产生类似排尿的反应，包括膀胱兴奋而无EUS激活。反应对刺激频率的依赖性与脉冲间隔有关，因为在10、33和100Hz时相同数量的脉冲产生不同的反应。在SCT前及术后8小时，只要膀胱内含有最小量的液体，以33Hz刺激PN会产生膀胱收缩。只有具有足够刺激串持续时间的中等频率刺激在SCT前后会使EUS ENG活动降低。除了类似控尿的反应外，PN刺激还可引发类似排尿的反应，并且这种反应取决于刺激频率、刺激串持续时间和膀胱容量。通过阴部神经刺激来控制膀胱的两个主要功能的能力对于神经康复来说是一个令人兴奋的前景。
