A Microchannel Neuroprosthesis for Bladder Control After Spinal Cord Injury in Rat

Science Translational Medicine  06 Nov 2013:
Vol. 5, Issue 210, pp. 210ra155
DOI: 10.1126/scitranslmed.3007186

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Getting to the Root of Bladder Control

Injury to the spinal cord typically results in loss of conscious bladder emptying and the sensation of fullness. Currently, only limited treatment options are available, with most of the patients receiving catheterization. However, this is cumbersome and leads to urological complications including unsolicited episodes of bladder contraction, leading to inappropriate emptying. In a new study, Chew et al. design a “closed-loop” electronic device that can accurately record bladder filling from sensory nerves after spinal cord injury in rat. Using this information, bladder emptying can be artificially stimulated on demand by electrically modulating nerve firing. It is traditionally difficult to record robust neuronal activity from peripheral nerves in vivo. Typically, cuff electrodes are used to record from whole nerves, but produce poor signal quality and provide little indication of bladder filling. Through nerve microdissection, Chew et al. implanted fine-diameter nerves (“rootlets”) into insulated microchannels, recording action potential firing that accurately encoded bladder filling. The device had multiple microchannels for concurrent recording, greatly improving the resolution. Using this sensory information and by manipulating stimulation characteristics, the authors prevented the rat bladder from emptying inappropriately, and bladder contraction was initiated when desired. This work opens a new avenue for the design of a neuroprosthesis for bladder control after spinal cord injury.