Translating promising strategies for bowel and bladder management in spinal cord injury

Wheeler, Tracey; Bowel,; Groat, William de; Eisner, Kymberly; Emmanuel, Anton; French, Jennifer; Grill, Warren M.; Kennelly, Michael; Krassioukov, Andrei V.; Santacruz, Bruno Gallo; Biering‐Sørensen, Fin; Kleitman, Naomi

doi:10.1016/j.expneurol.2018.05.006

Cited by 53 publications

(28 citation statements)

References 49 publications

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“…In contrast, available studies support an important contribution of both NTs in visceral dysfunction, such as neurogenic detrusor overactivity (NDO). Spinal cord injury (SCI) is a major cause of autonomic dysfunctions, often resulting in the loss of voluntary control of bladder and bowel [189]. As most lesions occur at cervicothoracic spinal levels, damage to neuronal pathways controlling visceral organs is almost inevitable.…”

Section: Spinal Cord Injury and Visceral Dysfunction: Are Ngf And Bdnmentioning

confidence: 99%

“…In addition to the disruption of neuronal pathways controlling micturition, nerves involved in gut regulation are usually affected after spinal trauma [193]. Loss of neuronal inputs from CNS results in neurogenic bowel that is characterized by situations of faecal incontinence and constipation, but has a major impact on patients' quality of life, requiring strict daily management [189,194].…”

Section: Spinal Cord Injury and Visceral Dysfunction: Are Ngf And Bdnmentioning

confidence: 99%

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Partners in Crime: NGF and BDNF in Visceral Dysfunction

Coelho

Oliveira

Antunes-Lopes

et al. 2019

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: Neurotrophins (NTs), particularly Nerve Growth Factor (NGF) and Brain-Derived Neurotrophic Factor (BDNF), have attracted increasing attention in the context of visceral function for some years. Here, we examined the current literature and presented a thorough review of the subject. : After initial studies linking of NGF to cystitis, it is now well-established that this neurotrophin (NT) is a key modulator of bladder pathologies, including Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) and Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS. NGF is upregulated in bladder tissue and its blockade results in major improvements on urodynamic parameters and pain. Further studies expanded showed that NGF is also an intervenient in other visceral dysfunctions such as endometriosis and Irritable Bowel Syndrome (IBS). : More recently, BDNF was also shown to play an important role in the same visceral dysfunctions, suggesting that both NTs are determinant factors in visceral pathophysiological mechanisms. Manipulation of NGF and BDNF improves visceral function and reduce pain, suggesting that clinical modulation of these NTs may be important; however, much is still to be investigated before this step is taken. : Another active area of research is centered on urinary NGF and BDNF. Several studies show that both NTs can be found in the urine of patients with visceral dysfunction in much higher concentration than in healthy individuals, suggesting that they could be used as potential biomarkers. However, there are still technical difficulties to be overcome, including the lack of a large multicentre placebo-controlled studies to prove the relevance of urinary NTs as clinical biomarkers.

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Section: Spinal Cord Injury and Visceral Dysfunction: Are Ngf And Bdnmentioning

confidence: 99%

Section: Spinal Cord Injury and Visceral Dysfunction: Are Ngf And Bdnmentioning

confidence: 99%

Partners in Crime: NGF and BDNF in Visceral Dysfunction

Coelho

Oliveira

Antunes-Lopes

et al. 2019

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“…Dimarco and colleagues have published a series of papers describing improvements in respiratory function individuals with SCI using EES including increased cough and inspiratory function . However, recovering bowel and bladder function is considered the top consumer priority in the SCI and research communities . Reports using EES in rodent models of SCI and using transcutaneous stimulation in healthy macaques have shown efficacy in facilitating urinary function.…”

Section: Alternative Approaches and Strategiesmentioning

confidence: 99%

Emergence of Epidural Electrical Stimulation to Facilitate Sensorimotor Network Functionality After Spinal Cord Injury

Calvert

Grahn

Zhao

et al. 2019

Neuromodulation: Technology at the Neural Interface

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“…The side effects of anticholinergic medications include constipation, dry mouth, headaches, and blurred vision [17][18][19][20]. Thus, adequate and effective treatment of bladder dysfunction in persons with SCI remains a significant unmet need [21].…”

Section: Introductionmentioning

confidence: 99%

Spinal cord stimulation for the restoration of bladder function after spinal cord injury

Steadman

Grill

2020

Healthcare Technology Letters

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Spinal cord injury (SCI) results in the inability to empty the bladder voluntarily, and neurogenic detrusor overactivity (NDO) and detrusor sphincter dyssynergia (DSD) negatively impact both the health and quality of life of persons with SCI. Current approaches to treat bladder dysfunction in persons with SCI, including self-catheterisation and anticholinergic medications, are inadequate, and novel approaches are required to restore continence with increased bladder capacity, as well as to provide predictable and efficient on-demand voiding. Improvements in bladder function following SCI have been documented using a number of different modalities of spinal cord stimulation (SCS) in both persons with SCI and animal models, including SCS alone or SCS with concomitant activity-based training. Improvements include increased volitional voiding, voided volumes, bladder capacity, and quality of life, as well as decreases in NDO and DSD. Further, SCS is a well-developed therapy for chronic pain, and existing Food And Drug Administration (FDA)-approved devices provide a clear pathway to sustainable commercial availability and impact. However, the effective stimulation parameters and the appropriate timing and location of stimulation for SCS-mediated restoration of bladder function require further study, and studies are needed to determine underlying mechanisms of action.

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Translating promising strategies for bowel and bladder management in spinal cord injury

Cited by 53 publications

References 49 publications

Partners in Crime: NGF and BDNF in Visceral Dysfunction

Partners in Crime: NGF and BDNF in Visceral Dysfunction

Emergence of Epidural Electrical Stimulation to Facilitate Sensorimotor Network Functionality After Spinal Cord Injury

Spinal cord stimulation for the restoration of bladder function after spinal cord injury

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