Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, United States of America.
Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States of America.
J Neural Eng. 2022 Nov 22;19(6):066014. doi: 10.1088/1741-2552/aca0c2.
Epidural spinal cord stimulation (SCS) is a potential intervention to improve limb and autonomic functions, with lumbar stimulation improving locomotion and thoracic stimulation regulating blood pressure. Here, we asked whether sacral SCS could be used to target the lower urinary tract (LUT) and used a high-density epidural electrode array to test whether individual electrodes could selectively recruit LUT nerves.. We placed a high-density epidural SCS array on the dorsal surface of the sacral spinal cord and cauda equina of anesthetized cats and recorded the stimulation-evoked activity from nerve cuffs on the pelvic, pudendal and sciatic nerves.. Here we show that sacral SCS evokes responses in nerves innervating the bladder and urethra and that these nerves can be activated selectively. Sacral SCS always recruited the pelvic and pudendal nerves and selectively recruited both of these nerves in all but one animal. Individual branches of the pudendal nerve were always recruited as well. Electrodes that selectively recruited specific peripheral nerves were spatially clustered on the arrays, suggesting anatomically organized sensory pathways.This selective recruitment demonstrates a mechanism to directly modulate bladder and urethral function through known reflex pathways, which could be used to restore bladder and urethral function after injury or disease.
硬膜外脊髓刺激（SCS）是一种改善肢体和自主功能的潜在干预手段，其中腰部刺激可改善运动功能，而胸部刺激可调节血压。在这里，我们想知道骶部 SCS 是否可以用于靶向下尿路（LUT），并使用高密度硬膜外电极阵列来测试单个电极是否可以选择性地募集 LUT 神经。我们在麻醉猫的骶骨脊髓背侧和马尾上放置了高密度硬膜外 SCS 阵列，并从骨盆、阴部和坐骨神经上的神经袖带记录刺激诱发的活动。在这里，我们表明骶部 SCS 可诱发出支配膀胱和尿道的神经的反应，并且这些神经可以被选择性地激活。骶部 SCS 始终募集骨盆和阴部神经，并且在除一只动物以外的所有动物中均选择性地募集这两种神经。阴部神经的各个分支也总是被募集。选择性募集特定外周神经的电极在阵列上空间聚类，表明存在解剖组织感觉通路。这种选择性募集通过已知的反射途径证明了一种直接调节膀胱和尿道功能的机制，这可以用于在损伤或疾病后恢复膀胱和尿道功能。
