A Neural Electrode to Restore lost Functions of the Pudendal Nerve (NERF-PN).

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Bladder dysfunction (BD) and sexual dysfunction (SD) following spinal cord injury (SCI) are severe medical conditions that affect people’s quality of life. It is estimated that BD occurs in 70- 84% of SCI patients. SD cannot be restored in 50% of cases, where most of them are in the phase of family building. Urination requires the integration of somatic and autonomous efferent mechanisms to coordinate the activity of the visceral organs (bladder and urethra) with that of the striated urethral muscles. In SCI patients these connections are lesioned or disrupted, leading to the loss of control of the bladder and/ or the sphincter voiding and retention activity. In SD patients, a natural erection consists of the activation of psychogenic and reflexogenic pathways. In SCI patients, the interruption from the brain to the sacral nervous system leads to psychogenic SD. Today’s clinical solutions include for example the administration of pharmaceuticals or epineural sacral neuromodulation (ESN). ESN has been shown to be able to treat BD and SD. ESN may be applied whenever necessary, directly activating targeted nerve structures. Unfortunately, the success rate is still low, presumably due to non-specific nerve fiber stimulation. The key objective of this research proposal is to develop an intraneural electrode, which is tailored for the selective stimulation of the nerve fibers responsible for issues related to BD and SD. Based on previous experience NERF-PN will drastically increase the success rate of neurostimulation and provide a viable substitution for ESN. NERF-PN I will gain skills in the development and testing of intraneural electrodes for target-specific neural interfacing. Clean-room experience, project management, grant writing, and other transferable skills that I will acquire will help me with my future career plans. NERF-PN will have a significant impact on my long-term career goals and will bring me closer to my goal as an independent researcher and successful principal investigator.