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Feasibility of deep brain stimulation for controlling the lower urinary tract functions: An animal study
Authors:Shih-Ching Chen  Pei-Yi Chu  Tsung-Hsun Hsieh  Yu-Ting Li  Chih-Wei Peng
Affiliation:1. Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;2. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan;3. School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan;4. Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan;5. Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan;6. Graduate Institute of Neural Regenerative Medicine, Taipei Medical University, Taipei, Taiwan;7. Instrument Technology Research Center, National Applied Research Laboratories, Hsinchu, Taiwan;8. International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
Abstract:

Objective

To evaluate the feasibility of deep brain stimulation (DBS) and compare the potential of four DBS targets in rats for regulating bladder activity: the periaqueductal gray (PAG), locus coeruleus (LC), rostral pontine reticular nucleus (PnO), and pedunculopontine tegmental nucleus (PPTg).

Methods

A bipolar stimulating electrode was implanted. The effects of DBS on the inhibition and activation of micturition reflexes were investigated by using isovolumetric intravesical pressure recordings.

Results

PAG DBS at 2–2.5 V, PnO DBS at 2–2.5 V, and PPTg DBS at 1.75–2.5 V nearly completely inhibited reflexive isovolumetric bladder contractions. By contrast, LC DBS at 1.75 and 2 V slightly augmented reflexive isovolumetric bladder contractions in rats. DBSs on PnO and PPTg at higher intensities (2.5–5 V) demonstrated a higher success rate and larger contraction area evocation in activating bladder contractions in a partially filled bladder. DBS targeting the PPTg was most efficient in suppressing reflexive isovolumetric bladder contractions.

Conclusion

PPTg DBS demonstrated stable results and high potency for controlling bladder contractions. PPTg might be a promising DBS target for developing new neuromodulatory approaches for the treatment of bladder dysfunctions.

Significance

DBS could be a potential approach to manage bladder function under various conditions.
Keywords:Bladder dysfunction  Deep brain stimulation  Periaqueductal gray  Locus coeruleus  Rostral pontine reticular nucleus  Pedunculopontine tegmental nucleus  Micturition reflex
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