Closed-loop sacral neuromodulation for bladder function using dorsal root ganglia sensory feedback in an anesthetized feline model.
Overactive bladder patients suffer from a frequent, uncontrollable urge to urinate, which can lead to a poor quality of life. We aim to improve open-loop sacral neuromodulation therapy by developing a conditional stimulation paradigm using neural recordings from dorsal root ganglia (DRG) as sensory...
| Publicado en: | Medical & Biological Engineering & Computing Vol. 60; no. 5; pp. 1527 - 1541 |
|---|---|
| Autores principales: | , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
May2022
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156318899&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156318899 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01400118 PO0 jtl: Medical & Biological Engineering & Computing issn: 01400118 maglogo: N pubinfo: dt: May2022 vid: 60 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 156318899 156318899 NLM35349032 10.1007/s11517-022-02554-8 NLM35349032 156318899 ppf: 1527 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Closed-loop sacral neuromodulation for bladder function using dorsal root ganglia sensory feedback in an anesthetized feline model. aug: au: Ouyang, Zhonghua Barrera, Nikolas Sperry, Zachariah J. Bottorff, Elizabeth C. Bittner, Katie C. Zirpel, Lance Bruns, Tim M. affil: Biomedical Engineering Department, University of Michigan, Ann Arbor, MI, USA sug: subj: Electrotherapy Ganglia, Sensory Physiology Psychotherapy Cats Quality of Life Bladder Physiology Animals Scales Ferrans and Powers Quality of Life Index ab: Overactive bladder patients suffer from a frequent, uncontrollable urge to urinate, which can lead to a poor quality of life. We aim to improve open-loop sacral neuromodulation therapy by developing a conditional stimulation paradigm using neural recordings from dorsal root ganglia (DRG) as sensory feedback. Experiments were performed in 5 anesthetized felines. We implemented a Kalman filter-based algorithm to estimate the bladder pressure in real-time using sacral-level DRG neural recordings and initiated sacral root electrical stimulation when the algorithm detected an increase in bladder pressure. Closed-loop neuromodulation was performed during continuous cystometry and compared to bladder fills with continuous and no stimulation. Overall, closed-loop stimulation increased bladder capacity by 13.8% over no stimulation (p < 0.001) and reduced stimulation time versus continuous stimulation by 57.7%. High-confidence bladder single units had a reduced sensitivity during stimulation, with lower linear trendline fits and higher pressure thresholds for firing observed during stimulation trials. This study demonstrates the utility of decoding bladder pressure from neural activity for closed-loop control of sacral neuromodulation. An underlying mechanism for sacral neuromodulation may be a reduction in bladder sensory neuron activity during stimulation. Real-time validation during behavioral studies is necessary prior to clinical translation of closed-loop sacral neuromodulation. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|