Department of Physical Therapy and School of Health Sciences, and Center of Developmental Neuroscience, The College of Staten Island New York, United States of America. Biology Department, CUNY Graduate Center New York, United States of America.
J Neural Eng. 2017 Oct;14(5):056002. doi: 10.1088/1741-2552/aa76f2. Epub 2017 Aug 4.
Lower urinary tract (LUT) dysfunction is a monumental problem affecting quality of life following neurotrauma, such as spinal cord injury (SCI). Proper function of the bladder and its associated structures depends on coordinated activity of the neuronal circuitry in the spinal cord and brain. Disconnection between the spinal and brain centers controlling the LUT causes fundamental changes in the mechanisms involved in the micturition and storage reflexes. We investigated the effects of cathodal trans-spinal direct current stimulation (c-tsDCS) of the lumbosacral spine on bladder and external urinary sphincter (EUS) functions.
We used cystometry and electromyography (EMG), in mice with and without SCI.
c-tsDCS caused initiation of the micturition reflex in urethane-anesthetized normal mice with depressed micturition reflexes. This effect was associated with normalized EUS-EMG activity. Moreover, in urethane-anesthetized normal mice with expressed micturition reflexes, c-tsDCS increased the firing frequency, amplitude, and duration of EUS-EMG activity. These effects were associated with increased maximum intravesical pressure (P ) and intercontraction interval (ICI). In conscious normal animals, c-tsDCS caused significant increases in P , ICI, threshold pressure (P ), baseline pressure (P ), and number and amplitude of non-voiding contractions (NVC and P , respectively). In conscious mice with severe contusive SCI and overactive bladder, c-tsDCS increased P , ICI, and P , but decreased P , NVC, and P . c-tsDCS reduced the detrusor-overactivity/cystometry ratio, which is a measure of bladder overactivity associated with renal deterioration.
These results indicate that c-tsDCS induces robust modulation of the lumbosacral spinal-cord circuitry that controls the LUT.
下尿路(LUT)功能障碍是影响神经创伤后生活质量的重大问题,例如脊髓损伤(SCI)。膀胱及其相关结构的正常功能取决于脊髓和大脑中的神经元回路的协调活动。控制 LUT 的脊髓和大脑中枢之间的断开导致参与排尿和储存反射的机制发生根本变化。我们研究了腰骶部脊柱阴极经颅直流电刺激(c-tsDCS)对膀胱和外泌尿道括约肌(EUS)功能的影响。
我们使用膀胱测压法和肌电图(EMG),在有和没有 SCI 的小鼠中进行研究。
c-tsDCS 导致麻醉的正常小鼠的排尿反射开始,这些小鼠的排尿反射受到抑制。这种作用与 EUS-EMG 活动的正常化有关。此外,在麻醉的正常小鼠中,c-tsDCS 增加了 EUS-EMG 活动的发射频率、幅度和持续时间。这些作用与最大膀胱内压(P )和收缩间期(ICI)的增加有关。在清醒的正常动物中,c-tsDCS 导致 P 、ICI、阈值压力(P )、基础压力(P )、非排尿收缩(NVC)的数量和幅度显著增加。在伴有严重挫伤性 SCI 和过度活跃膀胱的清醒小鼠中,c-tsDCS 增加了 P 、ICI 和 P ,但降低了 P 、NVC 和 P 。c-tsDCS 降低了逼尿肌过度活动/膀胱测压比值,这是与肾脏恶化相关的膀胱过度活动的衡量标准。
这些结果表明,c-tsDCS 诱导了对控制 LUT 的腰骶脊髓回路的强大调节。