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

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).

Frontiers in systems neuroscience. 2020 Jul 22*** epublish ***

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

Institute of Translational Biomedicine, Saint-Petersburg State University, Saint-Petersburg, Russia., Pavlov Institute of Physiology, Russian Academy of Sciences (RAS), Saint-Petersburg, Russia., Clinic of High Medical Technology named after N.I. Pirogov St. Petersburg State University, Saint-Petersburg, Russia., Institute of Chemistry, Saint-Petersburg State University, Saint-Petersburg, Russia.