突发刺激在神经神经调节患者中引起膀和尿道压力增加,表明自主神经系统的潜在激活:试点研究
Perla Douven1, Sam Tilborghs2, Sigrid van de Borne2
1Department of Urology, Maastricht University Medical Center, The Netherlands; Department of Translational Neuroscience, School for Mental Health and Neuroscience (MHeNS), Maastricht University, The Netherlands.
概括
与常规SNM相比,SNM显著增加了膀和尿道压力,在患有过度活跃膀或尿的患者中. 这表明Burst SNM可能会提供更好的自主神经系统刺激,以获得更好的治疗结果.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 神经科学是一个神经科学.
- 生物医学工程 生物医学工程
背景情况:
- 圣神经调节 (SNM) 的疗效可能是次优的,需要参数优化.
- 爆发刺激,模仿生理神经发射,比传统的SNM具有潜在的改进.
- 过度活跃的膀 (OAB) 和非阻塞性尿 (NOUR) 是可能受益于增强SNM的条件.
研究的目的:
- 评估各种爆发性SNM模式对膀和尿道压力的影响.
- 为了比较爆发性SNM与OAB或NOUR患者常规 (Con-) SNM的影响.
主要方法:
- 六名为SNM植入神经线的患者在全身麻醉下将膀填充到50%的容量.
- 在Con-SNM和不同的SNM爆发频率 (10-20-40 Hz) 中测量了膀,尿道中部和近壁尿道压力,幅度各不相同.
- 刺激参数包括高达5mA的Con-SNM和4mA的爆发SNM.
主要成果:
- 爆发性SNM诱导了膀和尿道压力的大幅增加.
- 在一个患者中,Con-SNM导致尿道压力增加较轻,膀压力变化仅为适度.
- 与Con-SNM不同的是,爆发性SNM在靠近尿道的压力增加大于中尿道的压力增加.
结论:
- 爆发性SNM刺激了膀收缩,并引起了比Con-SNM更大的膀和靠近尿道的压力增加.
- 这些发现表明,爆发性SNM提供了更高程度的自主神经系统刺激.
- 个体爆发SNM参数 (频率,振幅) 是至关重要的,未来的研究应该探索在清醒患者的可行性和有效性.
相关概念视频
01:18Disorders of the Autonomic Nervous System
592
The autonomic nervous system (ANS) is an intricate network of nerves that controls functions such as the regulation of heart rate, digestion, and blood pressure regulation. When this system malfunctions, it can lead to various disorders that affect multiple bodily functions. One common feature of many autonomic disorders is the involvement of smooth blood vessels, which play a crucial role in regulating blood flow throughout the body.
Raynaud's disease, also known as Raynaud's...
Raynaud's disease, also known as Raynaud's...
592
01:26The Micturition Reflex
531
Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
531
01:18Neural Regulation of Blood Pressure
2.7K
The neural regulation of blood pressure involves intricate interactions between the autonomic nervous system (ANS) and cardiovascular system, ensuring adequate perfusion of tissues. This regulation primarily occurs through baroreceptor and chemoreceptor reflexes, involving both short-term and long-term mechanisms.
Baroreceptor Reflex
Baroreceptors, located in the carotid sinuses and aortic arch, detect changes in blood pressure. When blood pressure rises, these stretch-sensitive receptors...
Baroreceptor Reflex
Baroreceptors, located in the carotid sinuses and aortic arch, detect changes in blood pressure. When blood pressure rises, these stretch-sensitive receptors...
2.7K
01:22Muscle Stimulation Frequency
2.1K
The contraction strength of muscles is regulated by motor neurons, which modulate the frequency of action potentials dispatched to the motor units based on the body's requirements. This process of varying the muscle stimulation frequency allows muscles to contract with a force that is precisely tailored to the needs of the moment, whether lifting a feather or a heavy box.
Wave summation
At low firing rates, motor neurons induce individual twitch contractions in muscle fibers. These twitches...
Wave summation
At low firing rates, motor neurons induce individual twitch contractions in muscle fibers. These twitches...
2.1K
01:25The Sympathetic Nervous System
94.7K
Overview
94.7K
01:17Sympathetic Activation
5.2K
The sympathetic division can influence tissues and organs by releasing norepinephrine at peripheral synapses and distributing epinephrine and norepinephrine through the bloodstream. In times of crisis or stress, sympathetic activation occurs, which is regulated by sympathetic centers in the hypothalamus. As a result, sympathetic activation prepares the body for physical exertion, rapid ATP production, and heightened alertness, allowing individuals to respond effectively to challenging or...
5.2K