Superficial Peroneal Neuromodulation of Persistent Bladder Underactivity Induced by Prolonged Pudendal Afferent Nerve Stimulation in Cats

2021 ◽  
Author(s):  
Jialiang Chen ◽  
Anand Mohapatra ◽  
Jun Zhao ◽  
Yihua Zhong ◽  
Bing Shen ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Pudendal Nerve ◽  
Bladder Capacity ◽  
Skin Surface ◽  
Thigh Muscle ◽  
Contraction Amplitude ◽  
Nerve Cuff ◽  
Cuff Electrodes ◽  
Nerve Cuff Electrodes ◽  
Bladder Underactivity

The purpose of this study is to determine if superficial peroneal nerve stimulation (SPNS) can reverse persistent bladder underactivity induced by prolonged pudendal nerve stimulation (PNS). In 16 α‐chloralose anesthetized cats, PNS and SPNS were applied by nerve cuff electrodes. Skin surface electrodes were also used for SPNS. Bladder underactivity consisting of a significant increase in bladder capacity to 157.8±10.9% of control and a significant reduction in bladder contraction amplitude to 56.0±5.0% of control was induced by repetitive (4-16 times) application of 30-min PNS. SPNS (1 Hz, 0.2 ms) at 1.5 to 2 times threshold intensity (T) for inducing posterior thigh muscle contractions was applied either continuously (SPNSc) or intermittently (SPNSi) during a cystometrogram (CMG) to determine if the stimulation can reverse the PNS-induced bladder underactivity. SPNSc or SPNSi applied by nerve cuff electrodes during the prolonged PNS inhibition significantly reduced bladder capacity to 124.4±10.7% and 132.4±14.2% of control, respectively, and increased contraction amplitude to 85.3±6.2% and 75.8±4.7%, respectively. Transcutaneous SPNSc and SPNSi also significantly reduced bladder capacity and increased contraction amplitude. Additional PNS applied during the bladder underactivity further increased bladder capacity, while SPNSc applied simultaneously with the PNS reversed the increase in bladder capacity. This study indicates that a non-invasive superficial peroneal neuromodulation therapy might be developed to treat bladder underactivity caused by abnormal pudendal nerve somatic afferent activation that is hypothesized to occur in patients with Fowler's syndrome.

Superficial Peroneal Neuromodulation of Nonobstructive Urinary Retention Induced by Prolonged Pudendal Afferent Activity in Cats

2022 ◽  
Author(s):  
Jialiang Chen ◽  
Yihua Zhong ◽  
Bing Shen ◽  
Jicheng Wang ◽  
Zhijun Shen ◽  
...  
Keyword(s):  
Urinary Retention ◽  
Nerve Stimulation ◽  
Skin Surface ◽  
Thigh Muscle ◽  
Afferent Activity ◽  
Surface Electrodes ◽  
Nerve Cuff ◽  
Cuff Electrodes ◽  
Nerve Cuff Electrodes ◽  
Fowler’S Syndrome

The purpose of this study is to determine if superficial peroneal nerve stimulation (SPNS) can improve nonobstructive urinary retention (NOUR) induced by prolonged pudendal nerve stimulation (PNS). In this exploratory acute study using 8 cats under anesthesia, PNS and SPNS were applied by nerve cuff electrodes. Skin surface electrodes were also used for SPNS. A double lumen catheter was inserted via the bladder dome for bladder infusion and pressure measurement and to allow voiding without a physical urethral outlet obstruction. The voided and postvoid residual (PVR) volumes were also recorded. NOUR induced by repetitive (4-13 times) application of 30-min PNS significantly (p<0.05) reduced voiding efficiency by 49.5±16.8% of control (78.3±7.9%) with a large PVR volume at 208.2±82.6% of control bladder capacity. SPNS (1 Hz, 0.2 ms) at 1.5 to 2 times threshold intensity (T) for inducing posterior thigh muscle contractions was applied either continuously (SPNSc) or intermittently (SPNSi) during cystometrograms to improve the PNS-induced NOUR. SPNSc and SPNSi applied by nerve cuff electrodes significantly (p<0.05) increased voiding efficiency to 74.5±18.9% and 67.0±15.3%, respectively, and reduced PVR volume to 54.5±39.0% and 88.3±56.0%, respectively. SPNSc and SPNSi applied non-invasively by skin surface electrodes also improved NOUR similar to the stimulation applied by a cuff electrode. This study indicates that abnormal pudendal afferent activity could be a pathophysiological cause for the NOUR occurring in Fowler's syndrome and a noninvasive superficial peroneal neuromodulation therapy might be developed to treat NOUR in patients with Fowler's syndrome.

scholarly journals Bladder underactivity induced by prolonged pudendal afferent activity in cats

2021 ◽  
Vol 320 (1) ◽  
pp. R80-R87
Author(s):  
Anand Mohapatra ◽  
Jialiang Chen ◽  
Jun Zhao ◽  
Yihua Zhong ◽  
Kody Armann ◽  
...  
Keyword(s):  
Pudendal Nerve ◽  
Bladder Capacity ◽  
Afferent Activity ◽  
Contraction Amplitude ◽  
Cuff Electrode ◽  
Central Inhibition ◽  
Bladder Activity ◽  
Bladder Underactivity ◽  
Cat Model ◽  
Fowler’S Syndrome

The purpose of this study was to determine the effects of pudendal nerve stimulation (PNS) on reflex bladder activity and develop an animal model of underactive bladder (UAB). In six anesthetized cats, a bladder catheter was inserted via the urethra to infuse saline and measure pressure. A cuff electrode was implanted on the pudendal nerve. After determination of the threshold intensity (T) for PNS to induce an anal twitch, PNS (5 Hz, 0.2 ms, 2 T or 4 T) was applied during cystometrograms (CMGs). PNS (4-6 T) of 30-min duration was then applied repeatedly until bladder underactivity was produced. Following stimulation, control CMGs were performed over 1.5-2 h to determine the duration of bladder underactivity. When applied during CMGs, PNS (2 T and 4 T) significantly ( P < 0.05) increased bladder capacity while PNS at 4 T also significantly ( P < 0.05) reduced bladder contraction amplitude, duration, and area under contraction curve. Repeated application of 30-min PNS for a cumulative period of 3-8 h produced bladder underactivity exhibiting a significantly ( P < 0.05) increased bladder capacity (173 ± 14% of control) and a significantly ( P < 0.05) reduced contraction amplitude (50 ± 7% of control). The bladder underactivity lasted more than 1.5-2 h after termination of the prolonged PNS. These results provide basic science evidence supporting the proposal that abnormal afferent activity from external urethral/anal sphincter could produce central inhibition that underlies nonobstructive urinary retention (NOUR) in Fowler’s syndrome. This cat model of UAB may be useful to investigate the mechanism by which sacral neuromodulation reverses NOUR in Fowler’s syndrome.

scholarly journals Saphenous nerve stimulation normalizes bladder underactivity induced by tibial nerve stimulation in cats

2018 ◽  
Vol 315 (2) ◽  
pp. F247-F253 ◽  
Author(s):  
Shun Li ◽  
Xing Li ◽  
Katherine Theisen ◽  
Jeffery Browning ◽  
Bing Shen ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Tibial Nerve ◽  
Control Level ◽  
Bladder Capacity ◽  
Saphenous Nerve ◽  
Bladder Pressure ◽  
Contraction Amplitude ◽  
Hindlimb Muscles ◽  
Tibial Nerve Stimulation ◽  
Bladder Underactivity

This study in α-chloralose-anesthetized cats aimed at investigating the bladder responses to saphenous nerve stimulation (SNS). A urethral catheter was used to infuse the bladder with saline and to record changes in bladder pressure. With the bladder fully distended, SNS at 1-Hz frequency and an intensity slightly below the threshold (T) for inducing an observable motor response of the hindlimb muscles induced large amplitude (40–150 cmH2O) bladder contractions. Application of SNS (1 Hz, 2–4T) during cystometrograms (CMGs), when the bladder was slowly (1–3 ml/min) infused with saline, significantly ( P < 0.05) increased the duration of the micturition contraction to >200% of the control without changing bladder capacity or contraction amplitude. Repeated application (1–8 times) of intense (4–8T intensity) 30-min tibial nerve stimulation (TNS) produced prolonged post-TNS inhibition that significantly ( P < 0.01) increased bladder capacity to 135.9 ± 7.6% and decreased the contraction amplitude to 44.1 ± 16.5% of the pre-TNS control level. During the period of post-TNS inhibition, SNS (1 Hz, 2–4T) applied during CMGs completely restored the bladder capacity and the contraction amplitude to the pre-TNS control level and almost doubled the duration of the micturition contraction. These results indicate that SNS at 1 Hz can facilitate the normal micturition reflex and normalize the reflex when it is suppressed during post-TNS inhibition. This study provides an opportunity to develop a novel neuromodulation therapy for underactive bladder using SNS.

scholarly journals Selective stimulation of the ferret abdominal vagus nerve with multi-contact nerve cuff electrodes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jonathan A. Shulgach ◽  
Dylan W. Beam ◽  
Ameya C. Nanivadekar ◽  
Derek M. Miller ◽  
Stephanie Fulton ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Fibers ◽  
The Body ◽  
Evoked Responses ◽  
Gi Tract ◽  
Selective Stimulation ◽  
Nerve Cuff ◽  
Cuff Electrodes ◽  
Nerve Cuff Electrodes ◽  
Stimulation Of

AbstractDysfunction and diseases of the gastrointestinal (GI) tract are a major driver of medical care. The vagus nerve innervates and controls multiple organs of the GI tract and vagus nerve stimulation (VNS) could provide a means for affecting GI function and treating disease. However, the vagus nerve also innervates many other organs throughout the body, and off-target effects of VNS could cause major side effects such as changes in blood pressure. In this study, we aimed to achieve selective stimulation of populations of vagal afferents using a multi-contact cuff electrode wrapped around the abdominal trunks of the vagus nerve. Four-contact nerve cuff electrodes were implanted around the dorsal (N = 3) or ventral (N = 3) abdominal vagus nerve in six ferrets, and the response to stimulation was measured via a 32-channel microelectrode array (MEA) inserted into the left or right nodose ganglion. Selectivity was characterized by the ability to evoke responses in MEA channels through one bipolar pair of cuff contacts but not through the other bipolar pair. We demonstrated that it was possible to selectively activate subpopulations of vagal neurons using abdominal VNS. Additionally, we quantified the conduction velocity of evoked responses to determine what types of nerve fibers (i.e., Aδ vs. C) responded to stimulation. We also quantified the spatial organization of evoked responses in the nodose MEA to determine if there is somatotopic organization of the neurons in that ganglion. Finally, we demonstrated in a separate set of three ferrets that stimulation of the abdominal vagus via a four-contact cuff could selectively alter gastric myoelectric activity, suggesting that abdominal VNS can potentially be used to control GI function.

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