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Real-Time Bladder Pressure Estimation for Closed-Loop Control in a Detrusor Overactivity Model.

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    This study developed a real-time bladder pressure estimation method using neural signals for closed-loop overactive bladder (OAB) treatment. This approach successfully triggered nerve stimulation, increasing bladder capacity and offering a potential improvement over current therapies.

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    Area of Science:

    • Biomedical Engineering
    • Neuroscience
    • Urology

    Background:

    • Overactive bladder (OAB) significantly impacts quality of life, with current treatments like continuous neurostimulation having limitations.
    • Closed-loop sensory feedback stimulation offers potential for improved OAB management by targeting bladder relaxation.
    • Real-time feedback is crucial for effective closed-loop neuromodulation therapies.

    Purpose of the Study:

    • To develop and validate a real-time bladder pressure estimation model using neural signals.
    • To demonstrate closed-loop neuromodulation for OAB treatment based on estimated bladder pressure.
    • To compare the stability of unsorted versus sorted neural signals for this application.

    Main Methods:

    • Implemented a Kalman filter to estimate bladder pressure from real-time, unsorted neural recordings of sacral dorsal root ganglia.
    • Validated the pressure estimation model across multiple bladder fill experiments in normal and simulated OAB conditions.
    • Demonstrated closed-loop neuromodulation by triggering pudendal nerve stimulation based on estimated bladder pressure.

    Main Results:

    • Achieved a high correlation coefficient (0.88 ± 0.16) for real-time bladder pressure estimation.
    • Closed-loop neuromodulation trials showed a 40% increase in bladder capacity.
    • Unsorted neural signals demonstrated comparable stability to sorted units with lower computational demands.

    Conclusions:

    • Decoding bladder pressure from neural activity is feasible for closed-loop neuromodulation in OAB.
    • This approach shows promise for enhancing bladder capacity and improving OAB treatment.
    • Further real-time validation in behavioral studies is needed before clinical application.