چكيده به لاتين
The urinary bladder consists of two main functions, storing urine up to specific volume (urinary continence) and complete emptying of the bladder at the proper time (micturition). Spinal cord injury (SCI) or neurological disorders can disrupt the bladder functions. In long-term, this disruption may reduce the quality of life of patients, urinary tract infection, and conclusively kidneys infection. To restore bladder functions, an invasive methods suchlike bladder neural prostheses can be an alternative approach to the patient whose refractory to pharmacotherapy or other minimally invasive procedures. The key to neural prostheses is to utilize functional electrical stimulation at the proper time. In this study first, we sought to close-loop control of the bladder micturition reflex by Residual volume signal as feedback and utilizing intraspinal stimulation at the sacral segments with the implementation of new stimulation strategy. To this end, we applied intermittent electrical stimulation with 33% duty cycle, pulse amplitude modulation, and modulation of the frequency into the spinal cord of intact rat model. Multichannel stimulation in synchronous and asynchronous mode was used to enhance voiding efficiency. The result of this stimulation pattern was bladder emptying with the voiding efficiency of 90.13 ± 10 % that was significantly improved compared with distention-evoked micturition (31.54 ± 13 %). At the next attempt, we have predicted the leakage by nominating a new method to increase bladder capacity in an overactive bladder of the rat model. LLGMN neural network by five steps ahead prediction could detect the leakage with a precision of 80%, 77% (sensitivity of 90%, 85%) in the normal and overactive group, respectively (by Trial-Trial training pattern). The results indicate that by providing an adequate pattern for intraspinal stimulation to control bladder micturition and also employing sophisticated methods to control incontinence, new neural prostheses can be recommended to restore bladder function in patients.
