VIRTUAL STROKE MODEL FOR STUDY OF BLADDER HYPERREFLEXIA

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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.