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Chunlin Hou - One of the best experts on this subject based on the ideXlab platform.
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reconstruction of Bladder Innervation below the level of spinal cord injury for inducing urination by achilles tendon to Bladder reflex contractions
2014Co-Authors: Haodong Lin, Hong-bin Zhong, Chunlin HouAbstract:Neuropathic Bladder caused by spinal cord injury (SCI) has been a challenge for researchers and clinicians for a long time. Most treatments focus on improving micturition, because there is no effective treatment for the spinal cord injury. The most common treatments for improving micturition are magnetic stimulation [1, 2], reconstruction of the detrusor with neuromuscular flaps [3, 4], and selective excision of the sacral nerve root [5]. However, satisfactory outcomes have been reported only for a few of these methods. Currently, the sacral root electrostimulation technique developed by Brindley is the only known effective clinical treatment, but the results with this treatment are inconsistent. Recently, surgical reconstruction of Bladder Innervation has been undertaken in paraplegic patients to upgrade their quality of life and to lower the mortality rate.
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Transfer of normal S1 nerve root to reinnervate atonic Bladder due to conus medullaris injury.
Muscle & nerve, 2012Co-Authors: Haodong Lin, Chunlin HouAbstract:Introduction: Neurogenic Bladder dysfunction after spinal cord injury (SCI) is a major medical and social problem. In this study we assessed the effectiveness of neurogenic Bladder reInnervation in patients with SCI using a normal S1 nerve root. Methods: Nine patients with Bladder dysfunction caused by injury to the low conus medullaris (S2–S5) underwent a novel surgical procedure in which the unilateral proximal end of the S1 ventral root (VR) was anastomosed to the distal end of the S2 and S3 VRs. Results: Seven patients regained satisfactory Bladder control within 8–12 months after VR microanastomosis. The average residual urine volume decreased from 186.0 ± 35.0 ml to 43.0 ± 10.0 ml, and no urinary infections occurred. Conclusions: These results suggest the effectiveness of Bladder Innervation by S1 nerve transfer, which could provide a new approach for the reconstruction of atonic Bladder function caused by low conus medullaris injuries. Muscle Nerve, 2013
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reconstructed Bladder Innervation above the level of spinal cord injury to produce urination by abdomen to Bladder reflex contractions case report
Journal of Neurosurgery, 2011Co-Authors: Haodong Lin, Chunlin Hou, Aimin ChenAbstract:Neurogenic Bladder dysfunction following spinal cord injury is a major medical and social problem for which there is no ideal treatment strategy. This paper describes the authors' attempts to establish Bladder reInnervation, by establishing an abdomen-to-Bladder reflex pathway, in a patient with an injury to the conus medullaris.
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Innervation of reconstructed Bladder above the level of spinal cord injury for inducing micturition by contractions of the abdomen-to-Bladder reflex arc.
Neurosurgery, 2010Co-Authors: Haodong Lin, Chunlin Hou, Aimin ChenAbstract:OBJECTIVE: To establish an artificial Bladder reflex arc in dogs via an abdominal reflex pathway above the level of spinal cord injury to reinnervate the neurogenic Bladder and restore controllable micturition. METHODS:Ten beagles were used in the experiment. We anastomosed the proximal end of the rightT1 2 ventral root and distal end of the right S2 ventral root by performing autogenous nerve grafting to build an abdomen-to-Bladder reflex, whereas the rightT1 2 dorsal root was kept intact. The early function of the reflex arc was evaluated by performing electrophysiological studies as well as by the measurement of intravesicular pressure and histological examination. RESULTS: Single focal stimulation of the rightT12 intercostal nerves elicited evoked action potentials at the right vesicular plexus before and after horizontal spinal cord transaction between the L4 and S3 levels. Bladder contraction was successfully initiated by trains of stimuli targeting the rightT12 intercostal nerves. The Bladder pressures and amplitude of the complex action potentials at the Bladder smooth muscles were unchanged after paraplegia was induced; they were comparable to those of the control. Prominent axonal sprouting was observed in the distal part of the nerve graft. CONCLUSION: Our data showed the effectiveness of Bladder Innervation above the level of spinal cord injury in inducing micturition by abdomen-to-Bladder reflex contractions and, therefore, might provide a new clinical approach for restoring Bladder function in individuals with paraplegia.
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clinical study of reconstructed Bladder Innervation below the level of spinal cord injury to produce urination by achilles tendon to Bladder reflex contractions clinical article
Journal of Neurosurgery, 2009Co-Authors: Haodong Lin, Chunlin Hou, Xianyou ZhenAbstract:Object Neurogenic Bladder dysfunction following spinal cord injury (SCI) is a major medical and social problem for which there is no ideal treatment strategy. In the present study, the authors analyze the effectiveness of neurogenic Bladder reInnervation in patients with SCIs by using Achilles tendon reflexes below the paraplegic level. Methods Spinal root anastomoses were performed in 12 paraplegic patients with hyperreflexic neurogenic Bladder and detrusor external sphincter dyssynergia (DESD) caused by complete suprasacral SCI, in an attempt to reinnervate the Bladder. The surgery anastomosed the unilateral proximal end of the S-1 ventral root and the distal end of the S-2 and/or S-3 ventral roots to build the Achilles tendon–to-Bladder reflex, while the S-1 dorsal root was kept intact as the trigger for micturition after axonal regeneration. All patients underwent urodynamic evaluation before surgery and at follow-up. Results The mean follow-up duration was 3 years. Of the 12 patients, 9 (75%) regaine...
E. Michelle Southard-smith - One of the best experts on this subject based on the ideXlab platform.
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Migration pathways of sacral neural crest during development of lower urogenital tract Innervation.
Developmental biology, 2017Co-Authors: Carrie B. Wiese, Karen K. Deal, Sara J. Ireland, V. Ashley Cantrell, E. Michelle Southard-smithAbstract:The migration and fate of cranial and vagal neural crest-derived progenitor cells (NCPCs) have been extensively studied; however, much less is known about sacral NCPCs particularly in regard to their distribution in the urogenital system. To construct a spatiotemporal map of NCPC migration pathways into the developing lower urinary tract, we utilized the Sox10-H2BVenus transgene to visualize NCPCs expressing Sox10. Our aim was to define the relationship of Sox10-expressing NCPCs relative to Bladder Innervation, smooth muscle differentiation, and vascularization through fetal development into adulthood. Sacral NCPC migration is a highly regimented, specifically timed process, with several potential regulatory mileposts. Neuronal differentiation occurs concomitantly with sacral NCPC migration, and neuronal cell bodies are present even before the pelvic ganglia coalesce. Sacral NCPCs reside within the pelvic ganglia anlagen through 13.5 days post coitum (dpc), after which they begin streaming into the Bladder body in progressive waves. Smooth muscle differentiation and vascularization of the Bladder initiate prior to Innervation and appear to be independent processes. In adult Bladder, the majority of Sox10+ cells express the glial marker S100β, consistent with Sox10 being a glial marker in other tissues. However, rare Sox10+ NCPCs are seen in close proximity to blood vessels and not all are S100β+, suggesting either glial heterogeneity or a potential nonglial role for Sox10+ cells along vasculature. Taken together, the developmental atlas of Sox10+ NCPC migration and distribution profile of these cells in adult Bladder provided here will serve as a roadmap for future investigation in mouse models of lower urinary tract dysfunction.
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Dynamic Expression of Serotonin Receptor 5-HT3A in Developing Sensory Innervation of the Lower Urinary Tract
Frontiers in neuroscience, 2017Co-Authors: K. Elaine Ritter, E. Michelle Southard-smithAbstract:Sensory afferent signaling is required for normal function of the lower urinary tract (LUT). Despite the wide prevalence of Bladder dysfunction and pelvic pain syndromes, few effective treatment options are available. Serotonin receptor 5-HT3A is a known mediator of visceral afferent signaling and has been implicated in Bladder function. However, basic expression patterns for this gene and others among developing Bladder sensory afferents that could be used to inform regenerative efforts aimed at treating deficiencies in pelvic Innervation are lacking. To gain greater insight into the molecular characteristics of Bladder sensory Innervation, we conducted a thorough characterization of Htr3a expression in developing and adult Bladder-projecting lumbosacral dorsal root ganglia (DRG) neurons. Using a transgenic Htr3a-EGFP reporter mouse line, we identified 5-HT3A expression at 10 days post coitus (dpc) in neural crest derivatives and in 12dpc lumbosacral DRG. Using immunohistochemical co-localization we observed Htr3a-EGFP expression in developing lumbosacral DRG that partially coincides with neuropeptides CGRP and Substance P and capsaicin receptor TRPV1. A majority of Htr3a-EGFP+ DRG neurons also express a marker of myelinated Aδ neurons, NF200. There was no co-localization of 5-HT3A with the TRPV4 receptor. We employed retrograde tracing in adult Htr3a-EGFP mice to quantify the contribution of 5-HT3A+ DRG neurons to Bladder afferent Innervation. We found that 5-HT3A is expressed in a substantial proportion of retrograde traced DRG neurons in both rostral (L1, L2) and caudal (L6, S1) axial levels that supply Bladder Innervation. Most Bladder-projecting Htr3a-EGFP+ neurons that co-express CGRP, Substance P, or TRPV1 are found in L1, L2 DRG, whereas Htr3a-EGFP+, NF200+ Bladder-projecting neurons are from the L6, S1 axial levels. Our findings contribute much needed information regarding the development of LUT Innervation and highlight the 5-HT3A serotonin receptor as a candidate for future studies of neurally mediated Bladder control.
Haodong Lin - One of the best experts on this subject based on the ideXlab platform.
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reconstruction of Bladder Innervation below the level of spinal cord injury for inducing urination by achilles tendon to Bladder reflex contractions
2014Co-Authors: Haodong Lin, Hong-bin Zhong, Chunlin HouAbstract:Neuropathic Bladder caused by spinal cord injury (SCI) has been a challenge for researchers and clinicians for a long time. Most treatments focus on improving micturition, because there is no effective treatment for the spinal cord injury. The most common treatments for improving micturition are magnetic stimulation [1, 2], reconstruction of the detrusor with neuromuscular flaps [3, 4], and selective excision of the sacral nerve root [5]. However, satisfactory outcomes have been reported only for a few of these methods. Currently, the sacral root electrostimulation technique developed by Brindley is the only known effective clinical treatment, but the results with this treatment are inconsistent. Recently, surgical reconstruction of Bladder Innervation has been undertaken in paraplegic patients to upgrade their quality of life and to lower the mortality rate.
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Transfer of normal S1 nerve root to reinnervate atonic Bladder due to conus medullaris injury.
Muscle & nerve, 2012Co-Authors: Haodong Lin, Chunlin HouAbstract:Introduction: Neurogenic Bladder dysfunction after spinal cord injury (SCI) is a major medical and social problem. In this study we assessed the effectiveness of neurogenic Bladder reInnervation in patients with SCI using a normal S1 nerve root. Methods: Nine patients with Bladder dysfunction caused by injury to the low conus medullaris (S2–S5) underwent a novel surgical procedure in which the unilateral proximal end of the S1 ventral root (VR) was anastomosed to the distal end of the S2 and S3 VRs. Results: Seven patients regained satisfactory Bladder control within 8–12 months after VR microanastomosis. The average residual urine volume decreased from 186.0 ± 35.0 ml to 43.0 ± 10.0 ml, and no urinary infections occurred. Conclusions: These results suggest the effectiveness of Bladder Innervation by S1 nerve transfer, which could provide a new approach for the reconstruction of atonic Bladder function caused by low conus medullaris injuries. Muscle Nerve, 2013
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reconstructed Bladder Innervation above the level of spinal cord injury to produce urination by abdomen to Bladder reflex contractions case report
Journal of Neurosurgery, 2011Co-Authors: Haodong Lin, Chunlin Hou, Aimin ChenAbstract:Neurogenic Bladder dysfunction following spinal cord injury is a major medical and social problem for which there is no ideal treatment strategy. This paper describes the authors' attempts to establish Bladder reInnervation, by establishing an abdomen-to-Bladder reflex pathway, in a patient with an injury to the conus medullaris.
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Innervation of reconstructed Bladder above the level of spinal cord injury for inducing micturition by contractions of the abdomen-to-Bladder reflex arc.
Neurosurgery, 2010Co-Authors: Haodong Lin, Chunlin Hou, Aimin ChenAbstract:OBJECTIVE: To establish an artificial Bladder reflex arc in dogs via an abdominal reflex pathway above the level of spinal cord injury to reinnervate the neurogenic Bladder and restore controllable micturition. METHODS:Ten beagles were used in the experiment. We anastomosed the proximal end of the rightT1 2 ventral root and distal end of the right S2 ventral root by performing autogenous nerve grafting to build an abdomen-to-Bladder reflex, whereas the rightT1 2 dorsal root was kept intact. The early function of the reflex arc was evaluated by performing electrophysiological studies as well as by the measurement of intravesicular pressure and histological examination. RESULTS: Single focal stimulation of the rightT12 intercostal nerves elicited evoked action potentials at the right vesicular plexus before and after horizontal spinal cord transaction between the L4 and S3 levels. Bladder contraction was successfully initiated by trains of stimuli targeting the rightT12 intercostal nerves. The Bladder pressures and amplitude of the complex action potentials at the Bladder smooth muscles were unchanged after paraplegia was induced; they were comparable to those of the control. Prominent axonal sprouting was observed in the distal part of the nerve graft. CONCLUSION: Our data showed the effectiveness of Bladder Innervation above the level of spinal cord injury in inducing micturition by abdomen-to-Bladder reflex contractions and, therefore, might provide a new clinical approach for restoring Bladder function in individuals with paraplegia.
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clinical study of reconstructed Bladder Innervation below the level of spinal cord injury to produce urination by achilles tendon to Bladder reflex contractions clinical article
Journal of Neurosurgery, 2009Co-Authors: Haodong Lin, Chunlin Hou, Xianyou ZhenAbstract:Object Neurogenic Bladder dysfunction following spinal cord injury (SCI) is a major medical and social problem for which there is no ideal treatment strategy. In the present study, the authors analyze the effectiveness of neurogenic Bladder reInnervation in patients with SCIs by using Achilles tendon reflexes below the paraplegic level. Methods Spinal root anastomoses were performed in 12 paraplegic patients with hyperreflexic neurogenic Bladder and detrusor external sphincter dyssynergia (DESD) caused by complete suprasacral SCI, in an attempt to reinnervate the Bladder. The surgery anastomosed the unilateral proximal end of the S-1 ventral root and the distal end of the S-2 and/or S-3 ventral roots to build the Achilles tendon–to-Bladder reflex, while the S-1 dorsal root was kept intact as the trigger for micturition after axonal regeneration. All patients underwent urodynamic evaluation before surgery and at follow-up. Results The mean follow-up duration was 3 years. Of the 12 patients, 9 (75%) regaine...
Michelle E Southardsmith - One of the best experts on this subject based on the ideXlab platform.
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serotonin receptor 5 ht3a affects development of Bladder Innervation and urinary Bladder function
Frontiers in Neuroscience, 2017Co-Authors: Elaine K Ritter, Chad M Vezina, Zunyi Wang, Dale E Bjorling, Michelle E SouthardsmithAbstract:The autonomic and sensory nervous systems are required for proper function of all visceral organs, including the lower urinary tract (LUT). Despite the wide prevalence of Bladder dysfunction, effective treatment options remain limited. Pelvic Innervation regenerative strategies are promising, but surprisingly little is known about the molecular factors driving the development of Bladder Innervation. Given prior evidence that serotonin receptor 5-HT3A is expressed early in LUT development and is an important mediator of adult Bladder function, we sought to determine if 5-HT3A is required for the development of autonomic Innervation of the Bladder. We found that 5-HT3A is expressed early in fetal mouse pelvic ganglia and is maintained through adulthood. Htr3a knockout male mice, but not females, exhibit increased urinary voiding frequency compared to wild type littermates. Analysis of lower urinary tract function via anesthetized cystometry revealed decreased voiding efficiency in male Htr3a mutants. Htr3a-/- mutant animals exhibit a transient disturbance of autonomic neuronal subtype markers (tyrosine hydroxylase and choline acetyl transferase) within the fetal pelvic ganglia, although the imbalance of neuronal subtype markers assayed is no longer apparent in adulthood. Loss of 5-HT3A activity results in a higher density of autonomic and sensory neuronal fibers supplying Bladder smooth muscle in both fetal and adult mice. Collectively, our findings highlight 5-HT3A as a critical component in the autonomic control of micturition and identify a novel role for this serotonin receptor in peripheral nervous system development.
Elaine K Ritter - One of the best experts on this subject based on the ideXlab platform.
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serotonin receptor 5 ht3a affects development of Bladder Innervation and urinary Bladder function
Frontiers in Neuroscience, 2017Co-Authors: Elaine K Ritter, Chad M Vezina, Zunyi Wang, Dale E Bjorling, Michelle E SouthardsmithAbstract:The autonomic and sensory nervous systems are required for proper function of all visceral organs, including the lower urinary tract (LUT). Despite the wide prevalence of Bladder dysfunction, effective treatment options remain limited. Pelvic Innervation regenerative strategies are promising, but surprisingly little is known about the molecular factors driving the development of Bladder Innervation. Given prior evidence that serotonin receptor 5-HT3A is expressed early in LUT development and is an important mediator of adult Bladder function, we sought to determine if 5-HT3A is required for the development of autonomic Innervation of the Bladder. We found that 5-HT3A is expressed early in fetal mouse pelvic ganglia and is maintained through adulthood. Htr3a knockout male mice, but not females, exhibit increased urinary voiding frequency compared to wild type littermates. Analysis of lower urinary tract function via anesthetized cystometry revealed decreased voiding efficiency in male Htr3a mutants. Htr3a-/- mutant animals exhibit a transient disturbance of autonomic neuronal subtype markers (tyrosine hydroxylase and choline acetyl transferase) within the fetal pelvic ganglia, although the imbalance of neuronal subtype markers assayed is no longer apparent in adulthood. Loss of 5-HT3A activity results in a higher density of autonomic and sensory neuronal fibers supplying Bladder smooth muscle in both fetal and adult mice. Collectively, our findings highlight 5-HT3A as a critical component in the autonomic control of micturition and identify a novel role for this serotonin receptor in peripheral nervous system development.
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Serotonin Receptor 5-HT3A Affects Development of Bladder Innervation and Urinary Bladder Function
Frontiers Media S.A., 2017Co-Authors: Elaine K Ritter, Chad M Vezina, Zunyi Wang, Dale E Bjorling, Michelle E. Southard-smithAbstract:The autonomic and sensory nervous systems are required for proper function of all visceral organs, including the lower urinary tract (LUT). Despite the wide prevalence of Bladder dysfunction, effective treatment options remain limited. Pelvic Innervation regenerative strategies are promising, but surprisingly little is known about the molecular factors driving the development of Bladder Innervation. Given prior evidence that serotonin receptor 5-HT3A is expressed early in LUT development and is an important mediator of adult Bladder function, we sought to determine if 5-HT3A is required for the development of autonomic Innervation of the Bladder. We found that 5-HT3A is expressed early in fetal mouse pelvic ganglia and is maintained through adulthood. Htr3a knockout male mice, but not females, exhibit increased urinary voiding frequency compared to wild type littermates. Analysis of LUT function via anesthetized cystometry revealed decreased voiding efficiency in male Htr3a mutants. Htr3a−/− mutant animals exhibit a transient disturbance of autonomic neuronal subtype markers (tyrosine hydroxylase and choline acetyl transferase) within the fetal pelvic ganglia, although the imbalance of neuronal subtype markers assayed is no longer apparent in adulthood. Loss of 5-HT3A activity results in a higher density of autonomic and sensory neuronal fibers supplying Bladder smooth muscle in both fetal and adult mice. Collectively, our findings highlight 5-HT3A as a critical component in the autonomic control of micturition and identify a novel role for this serotonin receptor in peripheral nervous system development