BLOCK OF EXTERNAL URETHRAL SPHINCTER CONTRACTION BY HIGH FREQUENCY ELECTRICAL STIMULATION OF PUDENDAL NERVE

2004 ◽  
Vol 172 (5) ◽  
pp. 2069-2072 ◽  
Author(s):  
CHANGFENG TAI ◽  
JAMES R. ROPPOLO ◽  
WILLIAM C. de GROAT
Keyword(s):  
Electrical Stimulation ◽  
High Frequency ◽  
Pudendal Nerve ◽  
Urethral Sphincter ◽  
External Urethral Sphincter ◽  
Stimulation Of

scholarly journals Electrical stimulation of the pudendal nerve promotes neuroregeneration and functional recovery from stress urinary incontinence in a rat model

2018 ◽  
Vol 315 (6) ◽  
pp. F1555-F1564 ◽  
Author(s):  
Hai-Hong Jiang ◽  
Qi-Xiang Song ◽  
Bradley C. Gill ◽  
Brian M. Balog ◽  
Raul Juarez ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Electrical Stimulation ◽  
Stress Urinary Incontinence ◽  
Rat Model ◽  
Pudendal Nerve ◽  
External Urethral Sphincter ◽  
Sham Stimulation ◽  
Point Pressure ◽  
Separate Cohort ◽  
Stimulation Of

The pudendal nerve can be injured during vaginal delivery of children, and slowed pudendal nerve regeneration has been correlated with development of stress urinary incontinence (SUI). Simultaneous injury to the pudendal nerve and its target muscle, the external urethral sphincter (EUS), during delivery likely leads to slowed neuroregeneration. The goal of this study was to determine if repeat electrical stimulation of the pudendal nerve improves SUI recovery and promotes neuroregeneration in a dual muscle and nerve injury rat model of SUI. Rats received electrical stimulation or sham stimulation of the pudendal nerve twice weekly for up to 2 wk after injury. A separate cohort of rats received sham injury and sham stimulation. Expression of brain-derived neurotrophic factor (BDNF) and βII-tubulin expression in Onuf’s nucleus were measured 2, 7, and 14 days after injury. Urodynamics, leak point pressure (LPP), and EUS electromyography (EMG) were recorded 14 days after injury. Electrical stimulation significantly increased expression of BDNF at all time points and βII-tubulin 1 and 2 wk after injury. Two weeks after injury, LPP and EUS EMG during voiding and LPP testing were significantly decreased compared with sham-injured animals. Electrical stimulation significantly increased EUS activity during voiding, although LPP did not fully recover. Repeat pudendal nerve stimulation promotes neuromuscular continence mechanism recovery possibly via a neuroregenerative response through BDNF upregulation in the pudendal motoneurons in this model of SUI. Electrical stimulation of the pudendal nerve may therefore improve recovery after childbirth and ameliorate symptoms of SUI by promoting neuroregeneration after injury.

scholarly journals Deep Brain Stimulation of the Posterior Insula in Chronic Pain: A Theoretical Framework

2021 ◽  
Vol 11 (5) ◽  
pp. 639
Author(s):  
David Bergeron ◽  
Sami Obaid ◽  
Marie-Pierre Fournier-Gosselin ◽  
Alain Bouthillier ◽  
Dang Khoa Nguyen
Keyword(s):  
Chronic Pain ◽  
Electrical Stimulation ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
High Frequency ◽  
Brain Lesion ◽  
Low Frequency ◽  
Posterior Insula ◽  
Deep Brain ◽  
Stimulation Of

Introduction: To date, clinical trials of deep brain stimulation (DBS) for refractory chronic pain have yielded unsatisfying results. Recent evidence suggests that the posterior insula may represent a promising DBS target for this indication. Methods: We present a narrative review highlighting the theoretical basis of posterior insula DBS in patients with chronic pain. Results: Neuroanatomical studies identified the posterior insula as an important cortical relay center for pain and interoception. Intracranial neuronal recordings showed that the earliest response to painful laser stimulation occurs in the posterior insula. The posterior insula is one of the only regions in the brain whose low-frequency electrical stimulation can elicit painful sensations. Most chronic pain syndromes, such as fibromyalgia, had abnormal functional connectivity of the posterior insula on functional imaging. Finally, preliminary results indicated that high-frequency electrical stimulation of the posterior insula can acutely increase pain thresholds. Conclusion: In light of the converging evidence from neuroanatomical, brain lesion, neuroimaging, and intracranial recording and stimulation as well as non-invasive stimulation studies, it appears that the insula is a critical hub for central integration and processing of painful stimuli, whose high-frequency electrical stimulation has the potential to relieve patients from the sensory and affective burden of chronic pain.

scholarly journals Intraoperative monitoring for tethered cord surgery: an update

2004 ◽  
Vol 16 (2) ◽  
pp. E8 ◽  
Author(s):  
Karl F. Kothbauer ◽  
Klaus Novak
Keyword(s):  
Electrical Stimulation ◽  
Anal Sphincter ◽  
External Anal Sphincter ◽  
Continuous Monitoring ◽  
Pudendal Nerve ◽  
Tethered Cord ◽  
Sensory Pathways ◽  
Functional Integrity ◽  
Muscle Responses ◽  
Stimulation Of

Object Intraoperative neurophysiological recording techniques have found increasing use in neurosurgical practice. The development of new recording techniques feasible while the patient receives a general anesthetic have improved their practical use in a similar way to the use of digital recording, documentation, and video technology. This review intends to provide an update on the techniques used and their validity. Methods Two principal methods are used for intraoperative neurophysiological testing during tethered cord release. Mapping identifies functional neural structures, namely nerve roots, and monitoring provides continuous information on the functional integrity of motor and sensory pathways as well as reflex circuitry. Mapping is performed mostly by using direct electrical stimulation of a structure within the surgical field and recording at a distant site, usually a muscle. Sensory mapping can also be performed with peripheral stimulation and recording within the surgical site. Monitoring of the motor system is achieved with motor evoked potentials. These are evoked by transcranial electrical stimulation and recorded from limb muscles and the external anal sphincter. The presence or absence of muscle responses are the parameters monitored. Sensory potentials evoked by tibial or pudendal nerve stimulation and recorded from the dorsal columns via an epidurally inserted electrode and/or from the scalp as cortical responses are used to access the integrity of sensory pathways. Amplitudes and latencies of these responses are then interpreted. The bulbocavernosus reflex, with stimulation of the pudendal nerve and recording of muscle responses in the external anal sphincter, is used for continuous monitoring of the reflex circuitry. Presence or absence of this response is the pertinent parameter that is monitored. Conclusions Intraoperative neurophysiology provides a wide and reliable set of techniques for intraoperative identification of neural structures and continuous monitoring of their functional integrity.

HIGH-FREQUENCY MONOPOLAR ELECTRICAL STIMULATION OF THE RAT CEREBRAL CORTEX

Neurosurgery ◽  
2007 ◽  
Vol 60 (1) ◽  
pp. 189-197 ◽  
Author(s):  
Masahiro Oinuma ◽  
Kyouichi Suzuki ◽  
Takashi Honda ◽  
Masato Matsumoto ◽  
Tatsuya Sasaki ◽  
...  
Keyword(s):  
Cerebral Cortex ◽  
Electrical Stimulation ◽  
High Frequency ◽  
Rat Cerebral Cortex ◽  
Stimulation Of
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