Functional mapping of the lower urinary tract by epidural electrical stimulation of the spinal cord in decerebrated cat model

Scientific Reports, 2024 · DOI: 10.1038/s41598-024-54209-3 · Published: February 9, 2024

Simple Explanation

Neurological diseases can disrupt lower urinary tract functions. Spinal cord stimulation may improve urine storage and micturition control. This study maps detrusor and external urethral sphincter activity by stimulating different spinal cord levels in a cat model. The study found that stimulating the lower thoracic and upper lumbar spinal cord primarily recruited the detrusor muscle. Stimulation of all spinal cord sites activated the external urethral sphincter, with pronounced specificity in lower lumbar/upper sacral sections. These findings align with previous rat data and could inform novel neuromodulation therapies. The decerebrated cat model helps understand spinal and brain stem network roles in urinary system activity, without anesthetic influence.

Study Duration

Not specified

Participants

5 adult male cats

Evidence Level

Animal Model Study

Key Findings

1
Stimulation of the lower thoracic/upper lumbar spinal cord (T13-L1) primarily triggers responses in the detrusor muscle.
2
Responses in the external urethral sphincter (EUS) occur with stimulation of various spinal cord regions, but show pronounced specificity for lower lumbar/upper sacral sections (L6-S1).
3
During 5 Hz stimulation, rostral region EES increases detrusor EMG and bladder pressure, while caudal region EES increases EUS EMG signal.

Research Summary

This study mapped lower urinary tract (LUT) function by epidural electrical stimulation (EES) of the spinal cord in a decerebrated cat model, identifying spinal cord regions responsible for detrusor and external urethral sphincter (EUS) activation. The results showed that stimulation of the lower thoracic and upper lumbar spinal cord (T13-L1) mainly recruited the detrusor muscle, while the EUS was activated predominantly by stimulation of the lower lumbar/upper sacral sections (L7-S1). These findings align with previous rat data and suggest that this site-specificity is common in mammals. Understanding these spinal networks is crucial for developing novel, site-specific neuromodulation therapeutic approaches for LUT dysfunction.

Practical Implications

Targeted Neuromodulation Therapies

The identification of specific spinal cord regions that control detrusor and EUS activity could lead to more targeted and effective neuromodulation therapies for urinary dysfunction.

Improved Treatment Strategies for SCI

Understanding the spinal mechanisms that regulate LUT function may improve treatment strategies for patients with spinal cord injuries, addressing both motor and autonomic disturbances.

Future Research Directions

Further investigation of the optimal stimulation parameters and their translation between animal models and humans remains challenging. It should be determined if the same stimulation parameters can be used for the treatment of multiple dysfunctions.

Study Limitations

1
Study conducted on a decerebrated cat model, which may not fully represent the complexities of the intact human nervous system.
2
Small sample size (n=5) limits the generalizability of the findings.
3
The exact mechanisms of SCS action still needs to be investigated

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