A microchannel neuroprosthesis for bladder control after spinal cord injury in rat

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Daniel J. Chew - , University of Cambridge (Author)
  • Lan Zhu - , Queen Mary University of London (Author)
  • Evangelos Delivopoulos - , University of Reading (Author)
  • Ivan R. Minev - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Katherine M. Musick - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Charles A. Mosse - , University College London (Author)
  • Michael Craggs - , University College London (Author)
  • Nicholas Donaldson - , University College London (Author)
  • Stéphanie P. Lacour - , Swiss Federal Institute of Technology Lausanne (EPFL) (Author)
  • Stephen B. McMahon - , Queen Mary University of London (Author)
  • James W. Fawcett - , University of Cambridge (Author)

Abstract

A severe complication of spinal cord injury is loss of bladder function (neurogenic bladder), which is characterized by loss of bladder sensation and voluntary control of micturition (urination), and spontaneous hyperreflexive voiding against a closed sphincter (detrusor-sphincter dyssynergia). A sacral anterior root stimulator at low frequency can drive volitional bladder voiding, but surgical rhizotomy of the lumbosacral dorsal roots is needed to prevent spontaneous voiding and dyssynergia. However, rhizotomy is irreversible and eliminates sexual function, and the stimulator gives no information on bladder fullness. We designed a closed-loop neuroprosthetic interface that measures bladder fullness and prevents spontaneous voiding episodes without the need for dorsal rhizotomy in a rat model. To obtain bladder sensory information, we implanted teased dorsal roots (rootlets) within the rat vertebral column into microchannel electrodes, which provided signal amplification and noise suppression. As long as they were attached to the spinal cord, these rootlets survived for up to 3 months and contained axons and blood vessels. Electrophysiological recordings showed that half of the rootlets propagated action potentials, with firing frequency correlated to bladder fullness. When the bladder became full enough to initiate spontaneous voiding, high-frequency/amplitude sensory activity was detected. Voiding was abolished using a high-frequency depolarizing block to the ventral roots. A ventral root stimulator initiated bladder emptying at low frequency and prevented unwanted contraction at high frequency. These data suggest that sensory information from the dorsal root together with a ventral root stimulator could form the basis for a closed-loop bladder neuroprosthetic.

Details

Original languageEnglish
Article number210ra155
JournalScience translational medicine
Volume5
Issue number210
Publication statusPublished - 6 Nov 2013
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 24197736

Keywords

ASJC Scopus subject areas