Changes in afferent activity after spinal cord injury.
Changes in afferent activity after spinal cord injury.
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DOI：
10.1002/nau.20761
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发表时间：
2010
影响因子：
2
通讯作者：
Yoshimura, Naoki
中科院分区：
文献类型：
--
作者：
de Groat, William C.;Yoshimura, Naoki
关键词：
总结脊髓损伤后膀胱传入神经元特性的变化。正常和功能障碍膀胱传入通路的解剖学、免疫组织化学和药理学研究的文献综述。对动物的研究表明，排尿反射是由一个脊髓延髓途径介导的，该途径穿过位于头端脑干的协调中心（导水管周围灰质和脑桥排尿中心）。这种反射途径由小的有髓鞘（Aδ）膀胱传入神经激活，进而由参与排尿的自主控制的大脑皮层中的高级中心调节。颈或胸段脊髓损伤会破坏自主排尿，以及协调膀胱和括约肌功能的正常反射通路。脊髓损伤后，膀胱最初是无反射的，但随后由于脊髓排尿反射通路的出现而变得反射亢进。脊髓损伤后膀胱功能的恢复部分依赖于膀胱传入通路的可塑性和由无髓鞘、辣椒素敏感的C纤维膀胱传入神经元触发的反射的暴露。可塑性与膀胱传入神经元的形态学、化学和电学变化相关，并且似乎部分由脊髓和外周靶器官中释放的神经营养因子介导。腰骶部脊髓损伤可通过改变膀胱或脊髓的功能和化学环境，间接影响膀胱传入神经元的特性。
To summarize the changes that occur in the properties of bladder afferent neurons following spinal cord injury. Literature review of anatomical, immunohistochemical, and pharmacologic studies of normal and dysfunctional bladder afferent pathways. Studies in animals indicate that the micturition reflex is mediated by a spinobulbospinal pathway passing through coordination centers (periaqueductal gray and pontine micturition center) located in the rostral brain stem. This reflex pathway, which is activated by small myelinated (Aδ) bladder afferent nerves, is in turn modulated by higher centers in the cerebral cortex involved in the voluntary control of micturition. Spinal cord injury at cervical or thoracic levels disrupts voluntary voiding, as well as the normal reflex pathways that coordinate bladder and sphincter function. Following spinal cord injury, the bladder is initially areflexic but then becomes hyperreflexic due to the emergence of a spinal micturition reflex pathway. The recovery of bladder function after spinal cord injury is dependent in part on the plasticity of bladder afferent pathways and the unmasking of reflexes triggered by unmyelinated, capsaicin-sensitive, C-fiber bladder afferent neurons. Plasticity is associated with morphologic, chemical, and electrical changes in bladder afferent neurons and appears to be mediated in part by neurotrophic factors released in the spinal cord and the peripheral target organs. Spinal cord injury at sites remote from the lumbosacral spinal cord can indirectly influence properties of bladder afferent neurons by altering the function and chemical environment in the bladder or the spinal cord.
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影响因子：
2.7
作者：
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通讯作者：
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DOI：
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