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亡原因，每年产生超过300亿美元的医疗保健费用。大约30%的中风患者因各种损伤而永久残疾。排尿功能障碍是脑卒中患者长期发病的重要因素，表现为尿频、尿急和急迫性尿失禁。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的存在与额叶皮质（额顶叶）的梗死相关。类似地，动物实验性额叶皮层梗死在梗死发作后短时间内产生膀胱反射亢进。研究表明，脑卒中可引起皮质脊髓抑制解除，进而导致膀胱反射亢进。本研究旨在建立一种“虚拟脑卒中”动物模型，以可靠和重复地产生膀胱反射亢进。对人类志愿者的研究表明，低频磁刺激皮质产生中风样症状，特别是相当大的皮质脊髓去抑制。动物模型的发展将使我们能够研究脊髓机制的“虚拟中风”引起的膀胱反射亢进，并试图通过重复刺激膀胱传出抑制。我们希望这个项目可以导致发展一个更好的治疗中风相关的膀胱功能障碍。

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.