MALE UROGENITAL FUNCTION AND CHRONIC SPINAL CORD INJURY

参与控制/协调的神经机制 人们对泌尿生殖系统的功能知之甚少，导致功能的恢复。 在创伤性脊髓损伤后，这是一项艰巨的任务。在人类，脊髓 损伤主要发生在年轻男性，损害性功能，以及 大多数患者因为不能射精而不能生育。此外， 膀胱-括约肌协同失调是膀胱排尿功能障碍的常见原因。 脊髓引起的会阴运动神经元环路不协调 损伤引起的非运动性节段性反射回路的改变 男性的生殖功能和排尿，可能对这些有贡献 并发症。因为正常射精和排尿都需要完整的 节段性反射弧和脑干整合，近年来，我们已经有了 研制并鉴定了体内脑干-脊髓 电生理动物模型研究性行为的神经学原因 严重的胸中段脊髓损伤后的功能障碍。我们以前的 对该模型的研究表明，背部的慢性双侧损害 T8脊髓的3/5与(1)膀胱/性反射受损， (Ii)调节会阴肌肉功能的腰骶神经环路的变化 以及(Iii)远端之间上行和下行连接的丢失 泌尿生殖道和延髓网状结构(II/III-已确定 在终端电生理实验中)。建议的总体目标是 研究是使用这种脊柱-眼球-脊柱模型来解决重要的问题 关于平滑和横纹肌的神经控制/协调 慢性脊髓损伤后雄性大鼠性功能和膀胱功能的变化 脐带受伤。我们模型的一个独特优势在于我们能够专注于 整合来自多个盆腔内脏的信息。所获得的知识 从这些基本的科学实验中可以更具体地确定 应作为靶点的脊髓区域和特定神经回路 用于旨在改善控制/协调的治疗干预 慢性脊髓损伤后的性、膀胱和肠道功能。 并行的电生理、行为和神经解剖学研究包括 建议。

The neural mechanisms involved in the control/coordination of urogenital functions is poorly understood, making restoration of function following traumatic spinal cord injury a difficult task. In humans, spinal cord injury occurs predominantly in young males, compromises sexual function, and leaves most patients infertile because of an inability to ejaculate. Moreover, bladder voiding dysfunction is common due to bladder-sphincter dyssynergia. Incoordination of perineal motoneuron circuits, resulting from spinal cord injury-induced changes in non-locomotor segmental reflex circuits involved in male reproductive function and micturition, likely contributes to these complications. Since normal ejaculation and micturition require both an intact segmental reflex arc and brainstem integration, we have, in recent years, developed and characterized an in vivo brainstem-spinal cord electrophysiological animal model to study the neurological causes of sexual dysfunction following severe midthoracic spinal cord injury. Our previous studies with this model have shown that chronic bilateral lesions of the dorsal 3/5 of T8 spinal cord is correlated with (i) impaired bladder/sexual reflexes, (ii) changes in lumbosacral neural circuits mediating perineal muscle function and (iii) loss of ascending and descending connections between the distal urogenital tract and the medullary reticular formation (ii/iii - as determined in terminal electrophysiological experiments). The overall aim of the proposed research is to use this spino-bulbo-spinal model to address important questions regarding the neural control/coordination of smooth and striated muscles subserving sexual and bladder functions in male rats following chronic spinal cord injury. A unique benefit of our model lies in our ability to focus on the integration of information from multiple pelvic viscera. The knowledge gained from these basic scientific experiments will more specifically ascertain the spinal cord regions and the specific neural circuitry which should be targeted for therapeutic interventions designed to improve the control/coordination of sexual, bladder and bowel functions following chronic spinal cord injury. Parallel electrophysiological, behavioral and neuroanatomical studies are proposed.