“Skin-CNS-Bladder” Reflex Pathway for Micturition After Spinal Cord Injury and Its Underlying Mechanisms

Chen, Xiao; Groat, William C. de; Godec, Ciril J.; Dai, Chengpu; Xiao, Qing

doi:10.1097/00005392-199909010-00094

Cited by 65 publications

(64 citation statements)

References 14 publications

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“…End-to-end anastomosis of injured ventral roots to adjacent intact ventral roots has resulted in bladder improvements in rats (Xiao and Godec, 1994), cats (Carlsson and Sundin, 1968;Vorstman et al, 1986;Xiao et al, 1999), canines (Ruggieri et al, 2004), and humans (Carlsson and Sundin, 1980;Xiao et al, 2003). This procedure requires an additional lesion to uninjured neurons and a shift in function by the originally uninjured neurons to now reinnervate a new target.…”

Section: Reinnervation Of the Lut Function After Injurymentioning

confidence: 99%

“…This procedure requires an additional lesion to uninjured neurons and a shift in function by the originally uninjured neurons to now reinnervate a new target. Furthermore, the intact dorsal roots create a new somatic-CNS-bladder reflex circuitry, whereby scratching the skin in specific dermatomes may elicit bladder contractions (Xiao et al, 1999(Xiao et al, , 2003. Although nerve-to-nerve anastomosis requires peripheral nerve regeneration, our repair model differs in that CNS regeneration is also necessary for reestablishment of the micturition circuitry by the originally injured neurons without inflicting any additional lesions to uninjured neurons.…”

Section: Reinnervation Of the Lut Function After Injurymentioning

confidence: 99%

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Functional Reinnervation of the Rat Lower Urinary Tract after Cauda Equina Injury and Repair

Hoang

Pikov²,

Havton³

2006

J. Neurosci.

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Conus medullaris and/or cauda equina forms of spinal cord injury commonly result in a permanent loss of bladder function. Here, we developed a cauda equina injury and repair rodent model to investigate whether surgical implantation of avulsed lumbosacral ventral roots into the spinal cord can promote functional recovery of the lower urinary tract. Adult female rats underwent sham surgery (n ϭ 6), bilateral L5-S2 ventral root avulsion (VRA) injury (n ϭ 5), or bilateral L5-S2 VRA followed by an acute implantation of the avulsed L6 and S1 ventral roots into the conus medullaris (n ϭ 6). At 12 weeks after operation, the avulsed group demonstrated urinary retention, absence of bladder contractions and external urethral sphincter (EUS) electromyographic (EMG) activation during urodynamic recordings, increased bladder size, and retrograde death of autonomic and motoneurons in the spinal cord. In contrast, the implanted group showed reduced urinary retention, return of reflexive bladder voiding contractions coincident with EUS EMG activation, anatomical reinnervation of the EUS demonstrated by retrograde neuronal labeling, normalization of bladder size, and a significant neuroprotection of both autonomic and motoneurons. In addition, a positive correlation between motoneuronal survival and voiding efficiency was observed in the implanted group. Our results show that implantation of avulsed lumbosacral ventral roots into the spinal cord promotes reinnervation of the urinary tract and return of functional micturition reflexes, suggesting that this surgical repair strategy may also be of clinical interest after conus medullaris and cauda equina injuries.

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Section: Reinnervation Of the Lut Function After Injurymentioning

confidence: 99%

Section: Reinnervation Of the Lut Function After Injurymentioning

confidence: 99%

Functional Reinnervation of the Rat Lower Urinary Tract after Cauda Equina Injury and Repair

Hoang

Pikov²,

Havton³

2006

J. Neurosci.

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“…Xiao and associates established the skin-central nervous reflex pathway system for the treatment of neurogenic bladder through end-to-end anastomosis of left L4/L5 ventral VR (somatic nerves) to L6/S2 VR( autonomic nerve) in rats and cats, respectively [46,47]. Peters [48] and Xiao [49,50] demonstrated that the skin-central nervous reflex pathway system following endto-end anastomosis of L5 VR (somatic nerves) to S2/S3 VR (autonomic nerve) could recover controllable voiding function in the clinical trial.…”

Section: The Advantages Of Terminolateral Neurorrhaphy Of Autonomic-smentioning

confidence: 99%

Terminolateral Neurorrhaphy between Somatic Nerve and Autonomic Nerve

He¹,

Gao²,

Wen³

2018

Neuropsychiatry

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“…Restoring normal voiding function in spinal cord injury (SCI) patients is a great challenge for neurology [1] . Researches on restoring functional micturition have been mainly focused on electrical stimulation for decades and with progresses, but it is not yet the definitive solution for majority of SCI patients [2] .…”

Section: Introductionmentioning

confidence: 99%

Morphological changes of cholinergic nerve fibers in the urinary bladder after establishment of artificial somatic-autonomic reflex arc in rats

Wang

Wen

et al. 2007

Neurosci. Bull.

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ObjectiveTo establish an artificial somatic-autonomic reflex arc in rats and observe the following distributive changes of neural fibers in the bladder. Methods Adult Sprague-Dawley rats were randomly divided into three groups: control group, spinal cord injury (SCI) group, and reinnervation group. DiI retrograde tracing was used to verify establishment of the model and to investigate the transport function of the regenerated efferent axons in the new reflex arc. Choline acetyltransferase (ChAT) in the DiI-labeled neurons was detected by immunohistochemistry. Distribution of neural fibers in the bladder was observed by acetylcholine esterase staining. Results DiI-labeled neurons distributed mainly in the left ventral horn from L3 to L5, and some of them were also ChAT-positive. The neural fibers in the bladder detrusor reduced remarkably in the SCI group compared with the control (P < 0.05). After establishment of the somatic-autonomic reflex arc in the reinnervation group, the number of ipsilateral fibers in the bladder increased markedly compared with the SCI group (P < 0.05), though still much less than that in the control (P < 0.05). Conclusion The efferent branches of the somatic nerves may grow and replace the parasympathetic preganglionic axons through axonal regeneration. Acetylcholine is still the major neurotransmitter of the new reflex arc. The controllability of detrusor may be promoted when it is reinnervated by the pelvic ganglia efferent somatic motor fibers from the postganglionic axons.

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“Skin-CNS-Bladder” Reflex Pathway for Micturition After Spinal Cord Injury and Its Underlying Mechanisms

Cited by 65 publications

References 14 publications

Functional Reinnervation of the Rat Lower Urinary Tract after Cauda Equina Injury and Repair

Functional Reinnervation of the Rat Lower Urinary Tract after Cauda Equina Injury and Repair

Terminolateral Neurorrhaphy between Somatic Nerve and Autonomic Nerve

Morphological changes of cholinergic nerve fibers in the urinary bladder after establishment of artificial somatic-autonomic reflex arc in rats

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