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Reflex Bladder Activation via Pudendal Nerve and Intraurethral Stimulation Depends on Stimulation Pattern and Location

机译:通过pudendal神经和管腔刺激反射膀胱激活取决于刺激图案和位置

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Pudendal nerve (PN) stimulation and intraurethral stimulation via a catheter have been demonstrated previously to trigger reflex bladder contractions for 20-40 Hz and 2 & 20 Hz continuous stimuli, respectively. However, thorough studies of the stimulation parameter space and optimal urethral locations are required for translation to clinical feasibility studies for potential neural prostheses. Stimulation-evoked bladder activation was evaluated in fourteen male cats via PN stimulation or intraurethral stimulation before and after spinal transection. In all testing scenarios, the use of pulse bursting led to a greater evoked bladder pressure than with single-pulse continuous waveforms. PN stimulation evoked contractions with 1 Hz and 33 Hz stimuli before spinalization in eight cats. Post-spinalization testing in four cats only elicited excitation for 33 Hz stimuli. For PN stimulation, spinalization eliminated the excitability of low frequency stimulation. Intraurethral stimulation in the proximal and prostatic urethra (2 Hz and 33 Hz range stimuli) and the distal urethra (33 Hz range stimuli) evoked contractions in six cats before spinalization. After spinalization, intraurethral testing in five cats only evoked contractions in the distal and prostatic urethra using 33 Hz range stimuli. For intraurethral stimulation, spinalization eliminated both proximal and low frequency responses. This research improves the knowledge base of several main factors involved in the development of neuroprostheses for bladder control - optimal stimulation paradigms and the understanding of lower urinary tract neurophysiology.
机译:通过先前证明了通过导管刺激和辅助刺激,以触发20-40Hz和2和20Hz的连续刺激的反射膀胱收缩。然而,对刺激参数空间和最佳尿道位置的彻底研究是对潜在神经假肢的临床可行性研究来说。通过PN刺激或脊髓横衰竭前后的PN刺激或鼻内刺激评估刺激诱发的膀胱活化。在所有测试场景中,使用脉冲爆裂导致比单脉冲连续波形更大的诱发膀胱压力。 PN刺激在八只猫脊髓脊髓之前用1 Hz和33 Hz刺激诱发收缩。四种猫的脊髓脊髓化测试仅引发了33 Hz刺激的激励。对于PN刺激,脊髓化消除了低频刺激的兴奋性。在近端和前列腺尿道(2Hz和33 Hz系列刺激)中的鼻腔刺激和远端尿道(33 Hz系列刺激)在脊髓化之前唤起六只猫的收缩。在脊髓化后,五只猫中的辅助测量测试只使用33 Hz范围刺激诱发远端和前列腺尿道中的收缩。对于管腔刺激,脊髓化消除了近端和低频响应。该研究改善了涉及膀胱控制神经间质的几个主要因素的知识库 - 最佳刺激范例和对低尿路神经生理学的理解。

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