Praveen Rajneesh Chellappan, Liou Jian-Chiun, Hsieh Tsung-Hsun, Chin Hung-Yen, Peng Chih-Wei
School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan.
Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan.
Brain Sci. 2020 Nov 12;10(11):850. doi: 10.3390/brainsci10110850.
Traumatic brain injuries (TBIs) are a prime public health challenge with a high incidence of mortality, and also reflect severe economic impacts. One of their severe symptoms is bladder dysfunction. Conventional therapeutic methods are not effective in managing bladder dysfunction. Henceforth, a research endeavor was attempted to explore a new therapeutic approach for bladder dysfunction through deep brain stimulation (DBS) procedures in a TBI animal model.
TBI in this animal model was induced by the weight-drop method. All rats with an induced TBI were housed for 4 weeks to allow severe bladder dysfunction to develop. Subsequently, an initial urodynamic measurement, the simultaneous recording of cystometric (CMG) and external urethral sphincter electromyography (EUS-EMG) activity was conducted to evaluate bladder function. Further, standard DBS procedures with varying electrical stimulation parameters were executed in the target area of the pedunculopontine tegmental nucleus (PPTg). Simultaneously, urodynamic measurements were re-established to compare the effects of DBS interventions on bladder functions.
From the variable combinations of electrical stimulation, DBS at 50 Hz and 2.0 V, significantly reverted the voiding efficiency from 39% to 69% in TBI rats. Furthermore, MRI studies revealed the precise localization of the DBS electrode in the target area.
The results we obtained showed an insightful understanding of PPTg-DBS and its therapeutic applications in alleviating bladder dysfunction in rats with a TBI. Hence, the present study suggests that PPTg-DBS is an effective therapeutic strategy for treating bladder dysfunction.
创伤性脑损伤（TBI）是一项重大的公共卫生挑战，死亡率高，还会产生严重的经济影响。其严重症状之一是膀胱功能障碍。传统治疗方法在管理膀胱功能障碍方面效果不佳。因此，尝试通过在TBI动物模型中进行脑深部电刺激（DBS）程序来探索一种治疗膀胱功能障碍的新方法。
采用重物坠落法在该动物模型中诱导TBI。所有诱导TBI的大鼠饲养4周，以使严重的膀胱功能障碍发展。随后，进行初始尿动力学测量，同时记录膀胱测压（CMG）和尿道外括约肌肌电图（EUS-EMG）活动以评估膀胱功能。此外，在脚桥被盖核（PPTg）的目标区域执行具有不同电刺激参数的标准DBS程序。同时，重新进行尿动力学测量以比较DBS干预对膀胱功能的影响。
从电刺激的不同组合来看，50Hz和2.0V的DBS显著将TBI大鼠的排尿效率从39%提高到69%。此外，MRI研究揭示了DBS电极在目标区域的精确定位。
我们获得的结果显示了对PPTg-DBS及其在减轻TBI大鼠膀胱功能障碍方面的治疗应用的深刻理解。因此，本研究表明PPTg-DBS是治疗膀胱功能障碍的有效治疗策略。
