VIRTUAL STROKE MODEL FOR STUDY OF BLADDER HYPERREFLEXIA

描述(由申请人提供)： 中风是美国第三大死因，每年产生超过300亿美元的医疗费用。大约30%的中风患者患有各种损伤的永久性残疾。排尿功能障碍是卒中患者长期发病的重要因素，主要表现为尿频、尿急和尿失禁。这些症状通常是膀胱逼尿肌反射亢进的结果。膀胱逼尿肌反射亢进与额叶(额顶叶)的梗塞有关。类似地，实验性的动物额叶皮质梗塞在梗塞发作后的短时间内会产生膀胱反射亢进。已有研究表明，卒中可产生皮质脊髓去抑制，进而导致膀胱反射亢进。本研究旨在建立一种“虚拟卒中”的动物模型，以期可靠、重复性地产生膀胱反射亢进。对人类志愿者的研究表明，对大脑皮质的低频磁刺激会产生中风样症状，特别是相当大的皮质脊髓去抑制。动物模型的建立将使我们能够研究“虚拟中风”诱发的膀胱反射亢进的脊髓机制，并尝试通过重复刺激膀胱传出神经来抑制它。我们希望这一项目能够开发出一种更好的治疗中风相关膀胱功能障碍的方法。

DESCRIPTION (provided by applicant): Stroke is the third leading cause of death in the United States and produces more than $30 billion yearly in health care costs. About 30 percent of stroke victims are permanently disabled with a variety of impairments. Voiding dysfunction is important factor in long-term morbidity of stroke patients and is manifested as frequency, urgency and urge incontinence. These symptoms are generally a result of bladder detrusor hyperreflexia. The presence of bladder detrusor hyperreflexia is correlated with infarctions in the frontal cortex (frontoparietal lobes). Similarly, experimental frontal cortex infarction in animals produces bladder hyperreflexia within a short time after infarction onset. It has been demonstrated that stroke may produce corticospinal disinhibition, which then leads to bladder hyperreflexia. This study aims to develop an animal model of "virtual stroke" in order to reliably and repetitively produce bladder hyperreflexia. Studies in human volunteers indicate that low-frequency magnetic stimulation of the cortex produces stroke-like symptoms and, in particular, considerable corticospinal disinhibition. Development of the animal model will allow us to study spinal cord mechanisms of "virtual stroke"-evoked bladder hyperreflexia and to attempt its suppression by repetitive stimulation of bladder efferents. We hope that this project can lead to development of a better treatment of stroke-related bladder dysfunction.