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Conditional Electrical Stimulation in Animal and Human Models for Neurogenic
Bladder: Working Toward a Neuroprosthesis.
Authors Powell CR
Submitted By Charles Powell on 12/16/2016
Status Published
Journal Current bladder dysfunction reports
Year 2016
Date Published
Volume : Pages 11 : 379 - 385
PubMed Reference
Abstract Sacral neuromodulation has had a tremendous impact on the treatment of urinary
incontinence and lower urinary tract symptoms for patients with neurologic
conditions. This stimulation does not use real-time data from the body or input
from the patient. Incorporating this is the goal of those pursuing a
neuroprosthesis to enhance bladder function for these patients. Investigators
have demonstrated the effectiveness of conditional (also called closed-loop)
feedback in animal models as well as limited human studies. Dorsal genital
nerve, pudendal nerve, S3 afferent nerve roots, S1 and S2 ganglia have all been
used as targets for stimulation. Most of these have also been used as sources of
afferent nerve information using sophisticated nerve electrode arrays and
filtering algorithms to detect significant bladder events and even to estimate
the fullness of the bladder. There are problems with afferent nerve sensing,
however. Some of these include sensor migration and low signal to noise ratios.
Implantable pressure sensors have also been investigated that have their own
unique challenges, such as erosion and sensor drift. As technology improves, an
intelligent neuroprosthesis with the ability to sense significant bladder events
and stimulate as needed will evolve.


Investigators with authorship
NameInstitution
Charles PowellIndiana University-Purdue University-Indianapolis

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