Mohamed S Elkelini1, Igor Pravdivyi, Magdy M Hassouna. 1. Toronto Western Research Institute, Toronto, ON; Institute of Medical Science, University of Toronto and Department of Surgery, Division of Urology, University of Toronto, Toronto, ON.
Abstract
INTRODUCTION: : Sacral neuromodulation (SNM) is an effective treatment modality for several urological problems, including neurogenic bladder. However, the invasiveness of this technique makes it unsuitable for many patients. We present a novel transdermal amplitude-modulated signal (TAMS) that may provide a non-invasive alternative to implantable SNM to treat neurogenic detrusor overactivity (NDO). METHODS: : In this study, we investigated the mechanism of action of non-invasive SNM using TAMS on our established spinal cord injury (SCI) animal model. We demonstrated that spinally transected rats develop urinary bladder hyper-reflexia after 3 weeks of SCI, indicated by the presence of uninhibited contractions, increased resting pressure, increased threshold pressure and increased maximum voiding pressure. RESULTS: : Short-term neurostimulation affected urodynamics parameters by significantly reducing the threshold pressure (p = 0.02). Spinal transection also increased calcitonin gene-related protein (CGRP) concentration in the L6 dorsal root ganglia; whereas, neurostimulation significantly reduced CGRP concentration in L6 (p = 0.03). CONCLUSION: : TAMS caused a reduction in NDO by inhibiting C-fibre activity.
INTRODUCTION: : Sacral neuromodulation (SNM) is an effective treatment modality for several urological problems, including neurogenic bladder. However, the invasiveness of this technique makes it unsuitable for many patients. We present a novel transdermal amplitude-modulated signal (TAMS) that may provide a non-invasive alternative to implantable SNM to treat neurogenic detrusor overactivity (NDO). METHODS: : In this study, we investigated the mechanism of action of non-invasive SNM using TAMS on our established spinal cord injury (SCI) animal model. We demonstrated that spinally transected rats develop urinary bladder hyper-reflexia after 3 weeks of SCI, indicated by the presence of uninhibited contractions, increased resting pressure, increased threshold pressure and increased maximum voiding pressure. RESULTS: : Short-term neurostimulation affected urodynamics parameters by significantly reducing the threshold pressure (p = 0.02). Spinal transection also increased calcitonin gene-related protein (CGRP) concentration in the L6 dorsal root ganglia; whereas, neurostimulation significantly reduced CGRP concentration in L6 (p = 0.03). CONCLUSION: : TAMS caused a reduction in NDO by inhibiting C-fibre activity.
Authors: Bing Shen; James R Roppolo; Jeyakumar Subbaroyan; Anthony Diubaldi; Steve Wahlgren; William C de Groat; Changfeng Tai Journal: Neurourol Urodyn Date: 2011-03-14 Impact factor: 2.696
Authors: Naoki Yoshimura; Nelson E Bennett; Yukio Hayashi; Teruyuki Ogawa; Osamu Nishizawa; Michael B Chancellor; William C de Groat; Satoshi Seki Journal: J Neurosci Date: 2006-10-18 Impact factor: 6.167