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Intraspinal Microstimulation of Dorsolateral Funiculus for Coordinated Bladder Control.
Summary
Researchers explored electrical microstimulation of the lumbar dorsolateral funiculus (DLF) to restore bladder fullness sensation after spinal cord injury (SCI). This approach successfully triggered coordinated voiding, offering a potential sensory component for neuroprosthetics.
Area of Science:
- Neuroscience
- Biomedical Engineering
- Urology
Background:
- Neurogenic lower urinary tract dysfunction (NLUTD) is a severe complication of spinal cord injury (SCI), impacting quality of life and leading to infections and renal issues.
- Current treatments like clean intermittent catheterization (CIC) have poor adherence, and sacral anterior root stimulation (SARS) lacks sensory feedback.
Purpose of the Study:
- To investigate if electrical microstimulation of ascending bladder afferent pathways in the lumbar dorsolateral funiculus (DLF) can mimic bladder fullness signals.
- To establish proof-of-concept for the sensory component of a closed-loop neuroprosthetic system for bladder function restoration post-SCI.
Main Methods:
- Used custom intraspinal microelectrode arrays to map bladder-responsive neural activity in rat L2-L4 spinal segments during controlled bladder filling.
- Delivered patterned electrical microstimulation to DLF coordinates identified during bladder filling.
- Assessed evoked responses for coordinated voiding, intravesical pressure, external urethral sphincter (EUS) activity, and hindlimb motor activation.
Main Results:
- Highly localized neural responses within the DLF were identified, correlating with bladder filling.
- Microstimulation of DLF successfully triggered coordinated voiding in 91.7% of trials, with appropriate pressure and EUS activity.
- Evoked responses showed spatial specificity, without unintended hindlimb motor activation, unlike spinothalamic tract (STT) stimulation.
Conclusions:
- The lumbar DLF is a viable anatomical target for electrical microstimulation to restore bladder afferent signals.
- This study provides proof-of-concept for using DLF stimulation as the sensory component in a future closed-loop neuroprosthetic system for SCI patients.
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