Conception and implementation of an MRI-compatible device to elicit the bulbocavernosus reflex for an open spinal cord study.

Autor: Hoffman KA; Department of Urology, Houston Methodist Hospital, Houston, Texas, USA.; Houston Methodist Research Institute Translational Imaging Core, Houston, Texas, USA., Mazeaud C; Department of Urology, Nancy University Hospital, Nancy, France., Salazar BH; Department of Urology, Houston Methodist Hospital, Houston, Texas, USA., Thompson LN; Department of Urology, Houston Methodist Hospital, Houston, Texas, USA., Stampas A; McGovern Medical School, TIRR Memorial Hermann, University of Texas Health Science Center, Houston, Texas, USA., Karmonik C; Houston Methodist Research Institute Translational Imaging Core, Houston, Texas, USA., Khavari R; Department of Urology, Houston Methodist Hospital, Houston, Texas, USA.
Jazyk: angličtina
Zdroj: Neurourology and urodynamics [Neurourol Urodyn] 2024 Jun; Vol. 43 (5), pp. 1230-1237. Date of Electronic Publication: 2024 Apr 03.
DOI: 10.1002/nau.25461
Abstrakt: Objective: Functional MRI (fMRI) can be employed to assess neuronal activity in the central nervous system. However, investigating the spinal cord using fMRI poses several technical difficulties. Enhancing the fMRI signal intensity in the spinal cord can improve the visualization and analysis of different neural pathways, particularly those involved in bladder function. The bulbocavernosus reflex (BCR) is an excellent method for evaluating the integrity of the sacral spinal cord. Instead of stimulating the glans penis or clitoris, the BCR can be simulated comfortably by tapping the suprapubic region. In this study, we explain the necessity and development of a device to elicit the simulated BCR (sBCR) via suprapubic tapping while conducting an fMRI scan.
Methods: The device was successfully tested on a group of 20 healthy individuals. Two stimulation task block protocols were administered (empty vs. full bladder). Each block consisted of 40 s of suprapubic tapping followed by 40 s of rest, and the entire sequence was repeated four times.
Results: Our device can reliably and consistently elicit sBCR noninvasively as demonstrated by electromyographic recording of pelvic muscles and anal winking. Participants did note mild to moderate discomfort and urge to void during the full bladder task.
Conclusion: Our device demonstrates an efficacious approach to elicit sBCR within an MRI bore to assess sacral spinal cord functional activity without generating any significant motion artifacts.
Significance: This device can explore the mechanisms and processes controlling urinary, digestive, or sexual function within this region in humans.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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