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Afferent Stimulation to Evoke Recto-colonic Reflex for Colonic Motility

传入刺激引起直肠结肠反射以促进结肠运动

基本信息

批准号：
10320729
负责人：
DENNIS BOURBEAU
金额：
--
依托单位：
LOUIS STOKES CLEVELAND VA MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-01-01 至 2021-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10320729
关键词：
Acute Afferent Neurons Anesthesia procedures Animals Anus Bladder Caliber Caregivers Caring Chronic Clinical Clinical Trials Colon Constipation Data Defecation Dependence Development Development Plans Devices Diet Disease Efferent Neurons Electric Stimulation Electrodes Excision FPS-FES Oncogene Feasibility Studies Fecal Incontinence Feces Felis catus Fingers Functional disorder Future Goals Health Healthcare Systems Hour Human Individual Infrastructure Intake Intestines Liquid substance Location Manuals Measures Mechanical Stimulation Mechanics Motor Nervous System Trauma Outcome Measure Pacemakers Pathway interactions Pattern Pelvis Peripheral Peristalsis Pharmacologic Substance Process Quality of life Randomized Rectum Reflex action Rehabilitation therapy Research Research Personnel Schedule Sensory Sex Functioning Spinal Spinal cord injury Structure Suppositories Technology Testing Time Training United States Urethral sphincter Veterans Work base care costs career career development cell motility cohort colon distension cost design digital experimental study family support feasibility trial functional restoration gastrointestinal improved innovation insight nervous system disorder neuroprosthesis novel strategies pre-clinical pressure primary outcome programs public health relevance rectal relating to nervous system response spinal reflex standard of care

项目摘要

DESCRIPTION (provided by applicant): Following spinal cord injury, the colon is unable to evacuate stools via peristaltic propulsion. Losing bowel function can cause constipation, gastro-intestinal complications, and faecal incontinence, severely impacting health and quality of life. The standard of care for individuals with neurogenic bowel involves the design of a bowel program for predictable and effective elimination of the bowels. A bowel program includes diet, fluid intake, activity, and pharmaceutical (suppository) or mechanical rectal stimulation. However, the bowel routine can require over an hour or more to evacuate the bowels and this process typically requires the assistance of a caregiver, which adds to the cost of care and reduces independence. Restoring bowel function is considered a high priority, but remains a critically unmet need requiring further development. The objective of this project is twofold: 1) To explore sensory afferent stimulation as a means of increasing colon peristalsis and 2) To train Dennis Bourbeau to become a leading independent research, restoring pelvic functions lost to spinal cord injury or other neurological disorders. We propose preclinical and translational experiments to develop and evaluate an approach to improve colonic motility. Colonic motility is quantified by the rate, direction, and pressure of coordinated peristalsis of the colon to move stools. The majority of individuals with neurogenic bowel dysfunction use digital rectal stimulation to distend the rectum and evoke an excitatory recto-colonic reflex, which increases colonic motility and loads stool into the rectum for removal. The proposed approach would substitute digital rectal stimulation with electrical rectal stimulation, using electrical stimulation of sensory (afferent) neurons of te rectum to modulate the recto-colonic reflex. Preliminary data have shown that 1) the colon responds to electrical stimulation in animals and 2) that afferent electrical stimulation modulates other pelvic reflexes to restore function, including bladder inhibition, urethral sphincter inhibiton, and bladder excitation. We hypothesize that the recto-colonic reflex can be evoked via electrical stimulation of rectal afferents and provide clinically sufficient colonic motility. This work will provide new insights for the development of a sensory afferent stimulation-based neuroprosthetic device to restore bowel function following spinal cord injury. This research is integrated with Dennis Bourbeau's career development plan with the goal of training to become a leading investigator, focusing on rehabilitative therapies for loss of pelvic functions through sensory stimulation.

项目成果

期刊论文数量（12）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Neuromodulation for Functional Electrical Stimulation.

功能性电刺激的神经调节。

DOI：
10.1016/j.pmr.2018.12.011
发表时间：
2019
期刊：
Physical medicine and rehabilitation clinics of North America
影响因子：
1.7
作者：
Wilson,RichardD;Bryden,AnneM;Kilgore,KevinL;Makowski,Nathaniel;Bourbeau,Dennis;Kowalski,KrzysztofE;DiMarco,AnthonyF;Knutson,JaymeS
通讯作者：
Knutson,JaymeS

Needs, priorities, and attitudes of individuals with spinal cord injury toward nerve stimulation devices for bladder and bowel function: a survey.

DOI：
10.1038/s41393-020-00545-w
发表时间：
2020-11
期刊：
Spinal cord
影响因子：
2.2
作者：
Bourbeau D;Bolon A;Creasey G;Dai W;Fertig B;French J;Jeji T;Kaiser A;Kouznetsov R;Rabchevsky A;Santacruz BG;Sun J;Thor KB;Wheeler T;Wierbicky J
通讯作者：
Wierbicky J

An Interdisciplinary Approach to Reducing Opioid Prescriptions to Patients with Chronic Pain in a Spinal Cord Injury Center.

减少脊髓损伤中心慢性疼痛患者阿片类药物处方的跨学科方法。