Assessment of sacral spinal excitability using stimulus-response curves of the bulbocavernosus reflex

Miget, Gabriel; Hentzen, Claire; Turmel, Nicolas; Chesnel, C.; Breton, F. Le; Ismaël, Samer Sheikh; Kerdraon, J.; Amarenco, G.

doi:10.1016/j.clinph.2021.06.006

Cited by 1 publication

(3 citation statements)

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“…Although the exact afferent pathway responsible for this response remains poorly understood, the prevailing hypothesis suggests that the bladder wall tensor receptor is provoked, potentially amplified by bladder filling. [11][12][13] This discovery aligns with previous observations that suprapubic tapping serves as an excellent surrogate for BCR stimulation and may, in turn, enhance the fMRI signal intensity in the spinal cord, facilitating improved visualization.…”

Section: Introductionsupporting

confidence: 84%

“…They found that suprapubic stimulation reliably elicited the BCR without causing pain to the patient, and the resulting EMG response was comparable to that obtained through polysynaptic penis/clitoris stimulation. Although the exact afferent pathway responsible for this response remains poorly understood, the prevailing hypothesis suggests that the bladder wall tensor receptor is provoked, potentially amplified by bladder filling 11–13 . This discovery aligns with previous observations that suprapubic tapping serves as an excellent surrogate for BCR stimulation and may, in turn, enhance the fMRI signal intensity in the spinal cord, facilitating improved visualization.…”

Section: Introductionsupporting

confidence: 80%

“…Moreover, the data obtained from our healthy subjects serves as a reference point for future comparisons, particularly when investigating potential alterations in spinal neural activity in individuals with neurogenic LUT dysfunction stemming from various etiologies. As illustrated by Miget et al, 13 the BCR can effectively evaluate sacral spinal excitability in individuals with upper motor neuron injuries, underscoring the relevance and applicability of our device.…”

Section: Discussionsupporting

confidence: 56%

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Conception and implementation of an MRI‐compatible device to elicit the bulbocavernosus reflex for an open spinal cord study

Hoffman,

Mazeaud,

Salazar

et al. 2024

Neurourology and Urodynamics

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ObjectiveFunctional MRI (fMRI) can be employed to assess neuronal activity in the central nervous system. However, investigating the spinal cord using fMRI poses several technical difficulties. Enhancing the fMRI signal intensity in the spinal cord can improve the visualization and analysis of different neural pathways, particularly those involved in bladder function. The bulbocavernosus reflex (BCR) is an excellent method for evaluating the integrity of the sacral spinal cord. Instead of stimulating the glans penis or clitoris, the BCR can be simulated comfortably by tapping the suprapubic region. In this study, we explain the necessity and development of a device to elicit the simulated BCR (sBCR) via suprapubic tapping while conducting an fMRI scan.MethodsThe device was successfully tested on a group of 20 healthy individuals. Two stimulation task block protocols were administered (empty vs. full bladder). Each block consisted of 40 s of suprapubic tapping followed by 40 s of rest, and the entire sequence was repeated four times.ResultsOur device can reliably and consistently elicit sBCR noninvasively as demonstrated by electromyographic recording of pelvic muscles and anal winking. Participants did note mild to moderate discomfort and urge to void during the full bladder task.ConclusionOur device demonstrates an efficacious approach to elicit sBCR within an MRI bore to assess sacral spinal cord functional activity without generating any significant motion artifacts.SignificanceThis device can explore the mechanisms and processes controlling urinary, digestive, or sexual function within this region in humans.

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Section: Introductionsupporting

confidence: 84%

Section: Introductionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 56%

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