title: Initiation of bladder voiding with epidural stimulation in paralyzed, step trained rats.
abstract: The inability to control timely bladder emptying is one of the most serious challenges among the several functional deficits that occur after a complete spinal cord injury. Having demonstrated that electrodes placed epidurally on the dorsum of the spinal cord can be used in animals and humans to recover postural and locomotor function after complete paralysis, we hypothesized that a similar approach could be used to recover bladder function after paralysis. Also knowing that posture and locomotion can be initiated immediately with a specific frequency-dependent stimulation pattern and that with repeated stimulation-training sessions these functions can improve even further, we reasoned that the same two strategies could be used to regain bladder function. Recent evidence suggests that rats with severe paralysis can be rehabilitated with a multisystem neuroprosthetic training regime that counteracts the development of neurogenic bladder dysfunction. No data regarding the acute effects of locomotion on bladder function, however, were reported. In this study we show that enabling of locomotor-related spinal neuronal circuits by epidural stimulation also influences neural networks controlling bladder function and can play a vital role in recovering bladder function after complete paralysis. We have identified specific spinal cord stimulation parameters that initiate bladder emptying within seconds of the initiation of epidural stimulation. The clinical implications of these results are substantial in that this strategy could have a major impact in improving the quality of life and longevity of patients while simultaneously dramatically reducing ongoing health maintenance after a spinal cord injury.
authors.affiliation: Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Parag N
authors.initials: PN
authors.lastname: Gad
authors.affiliation: Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California, United States of America; Brain Research Institute, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Roland R
authors.initials: RR
authors.lastname: Roy
authors.affiliation: Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhong
authors.affiliation: Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Lu
authors.affiliation: Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California, United States of America; Pavlov Institute of Physiology, St. Petersburg, Russia.
authors.forename: Yury P
authors.initials: YP
authors.lastname: Gerasimenko
authors.affiliation: Department of Integrative Biology and Physiology, University of California Los Angeles, Los Angeles, California, United States of America; Department of Neurobiology, University of California Los Angeles, Los Angeles, California, United States of America; Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, United States of America; Brain Research Institute, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: V Reggie
authors.initials: VR
authors.lastname: Edgerton
mesh_terms: D000818:Animals; D004558:Electric Stimulation; D004566:Electrodes; D004576:Electromyography; D005260:Female; D008124:Locomotion; D010805:Physical Conditioning, Animal; D051381:Rats; D017207:Rats, Sprague-Dawley; D013116:Spinal Cord / Q000502:physiology*; D014554:Urination