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Variable patterned pudendal nerve stimuli improves reflex bladder activation.

Tim M Bruns1, Narendra Bhadra, Kenneth J Gustafson

  • 1Biomedical Engineering Department, Case Western Reserve University, and Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH 44106, USA. tmb30@case.edu

IEEE Transactions on Neural Systems and Rehabilitation Engineering : a Publication of the IEEE Engineering in Medicine and Biology Society
|April 12, 2008
PubMed
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Patterned pudendal nerve (PN) stimulation, using bursts of pulses, significantly improved reflex bladder contractions compared to continuous stimulation. This finding enhances neuroprosthetics for bladder control.

Area of Science:

  • Neuroscience
  • Biomedical Engineering
  • Urology

Background:

  • Reflex bladder activation is achievable via pudendal nerve (PN) afferent stimulation.
  • Previous studies utilized continuous stimulation frequencies (20-33 Hz).
  • Physiological patterned stimuli may offer superior neuronal circuit activation.

Purpose of the Study:

  • To evaluate variable stimulation patterns of the pudendal nerve (PN) for enhancing reflex bladder excitation.
  • To compare the efficacy of patterned versus continuous PN stimulation for eliciting bladder contractions.
  • To explore a wider range of stimulation parameters for improved bladder neuroprosthetics.

Main Methods:

  • Unilateral PN nerve cuffs were implanted in male cats.
  • Pudendal nerve stimulation (0.5-100 Hz) was applied under isovolumetric conditions.

Related Experiment Videos

  • Stimulation involved continuous pulses and patterned bursts (2-10 pulses at 100-200 Hz).

    • Main Results:

    • Stimulus-evoked reflex bladder contractions were achieved in eight cats.
    • Patterned stimulation (bursting) yielded significantly larger bladder responses (52.0+/-44.5%) than continuous stimulation.
    • Effective bladder excitation was observed even at a low continuous frequency of 1 Hz.

    Conclusions:

    • Variable patterned pulse bursting enhances evoked reflex bladder pressures.
    • Patterned stimulation expands the parameter space for effective bladder excitation.
    • Optimized bladder excitation via patterned PN stimulation can improve neuroprosthesis efficacy for bladder control.