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硬膜外脊髓刺激对逼尿肌和尿道外括约肌的位点特异性神经调节

Site-Specific Neuromodulation of Detrusor and External Urethral Sphincter by Epidural Spinal Cord Stimulation.

作者信息

Sysoev Yuriy, Bazhenova Elena, Lyakhovetskii Vsevolod, Kovalev Gleb, Shkorbatova Polina, Islamova Regina, Pavlova Natalia, Gorskii Oleg, Merkulyeva Natalia, Shkarupa Dmitry, Musienko Pavel

机构信息

Institute of Translational Biomedicine, Saint-Petersburg State University, Saint-Petersburg, Russia.

Department of Pharmacology and Clinical Pharmacology, Saint-Petersburg State Chemical Pharmaceutical University, Saint-Petersburg, Russia.

出版信息

Front Syst Neurosci. 2020 Jul 22;14:47. doi: 10.3389/fnsys.2020.00047. eCollection 2020.

DOI:10.3389/fnsys.2020.00047
PMID:32774243
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7387722/
Abstract

Impairments of the lower urinary tract function including urine storage and voiding are widely spread among patients with spinal cord injuries. The management of such patients includes bladder catheterization, surgical and pharmacological approaches, which reduce the morbidity from urinary tract-related complications. However, to date, there is no effective treatment of neurogenic bladder and restoration of urinary function. In the present study, we examined neuromodulation of detrusor (Detr) and external urethral sphincter by epidural electrical stimulation (EES) of lumbar and sacral regions of the spinal cord in chronic rats. To our knowledge, it is the first chronic study where detrusor and external urethral sphincter signals were recorded simultaneously to monitor their neuromodulation by site-specific spinal cord stimulation (SCS). The data obtained demonstrate that activation of detrusor muscle mainly occurs during the stimulation of the upper lumbar (L1) and lower lumbar (L5-L6) spinal segments whereas external urethral sphincter was activated predominantly by sacral stimulation. These findings can be used for the development of neurorehabilitation strategies based on spinal cord epidural stimulation for autonomic function recovery after severe spinal cord injury (SCI).

摘要

包括储尿和排尿功能在内的下尿路功能障碍在脊髓损伤患者中广泛存在。这类患者的治疗方法包括膀胱插管、手术及药物治疗，这些方法可降低泌尿系统相关并发症的发病率。然而，迄今为止，尚无治疗神经源性膀胱和恢复排尿功能的有效方法。在本研究中，我们检测了慢性大鼠脊髓腰段和骶段硬膜外电刺激（EES）对逼尿肌（Detr）和尿道外括约肌的神经调节作用。据我们所知，这是第一项同时记录逼尿肌和尿道外括约肌信号以监测特定部位脊髓刺激（SCS）对其神经调节作用的慢性研究。所获得的数据表明，逼尿肌的激活主要发生在刺激上腰段（L1）和下腰段（L5-L6）脊髓节段时，而尿道外括约肌主要由骶段刺激激活。这些发现可用于开发基于脊髓硬膜外刺激的神经康复策略，以促进严重脊髓损伤（SCI）后自主功能的恢复。

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