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

脊髓损伤(SCI)后的膀胱功能障碍(BD)和性功能障碍(SD)是严重影响人们生活质量的疾病。据估计，BD发生在70-84%的脊髓损伤患者中。50%的病例无法恢复SD，其中大部分处于家庭建设阶段。排尿需要躯体和自主传出机制的整合，以协调内脏器官(膀胱和尿路)和横纹尿道肌的活动。在脊髓损伤患者中，这些连接受损或中断，导致膀胱失去控制和/或括约肌排尿和保留活动。在SD患者中，自然勃起包括心理和反射通路的激活。在脊髓损伤患者中，从大脑到骶骨神经系统的中断导致了心因性SD。例如，今天的临床解决方案包括给药或神经外膜神经调节(ESN)。ESN已被证明能够治疗BD和SD。必要时可应用ESN，直接激活靶向神经结构。不幸的是，成功率仍然很低，可能是由于非特异性神经纤维刺激所致。这项研究计划的关键目标是开发一种神经内电极，该电极专为选择性刺激负责BD和SD相关问题的神经纤维而定制。根据以往的经验，NERF-PN将极大地提高神经刺激的成功率，并为ESN提供一种可行的替代品。NERF-PNI将获得用于靶向特定神经接口的神经内电极的开发和测试技能。洁净室经验、项目管理、赠款撰写和其他我将获得的可转让技能将有助于我未来的职业规划。NERF-PN将对我的长期职业目标产生重大影响，并将使我更接近成为一名独立研究员和成功的首席研究员的目标。

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.