Feasibility of Real-Time Conditional Sacral Neuromodulation Using Wireless Bladder Pressure Sensor
| Autor: | Steve J. A. Majerus, Thaddeus S. Brink, Margot S. Damaser, Sarah J. Offutt, Ian Mcadams, Vincent M. Vasoli, Lance Zirpel |
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| Rok vydání: | 2021 |
| Předmět: |
Sacrum
Computer science medicine.medical_treatment Biomedical Engineering Electric Stimulation Therapy Internal Medicine medicine Animals Wireless Neurostimulation Sheep Urinary Bladder Overactive business.industry General Neuroscience Rehabilitation medicine.disease Bladder pressure Pressure sensor Neuromodulation (medicine) Treatment Outcome Overactive bladder Proof of concept Feasibility Studies Female business Wireless sensor network Biomedical engineering |
| Zdroj: | IEEE Transactions on Neural Systems and Rehabilitation Engineering. 29:2067-2075 |
| ISSN: | 1558-0210 1534-4320 |
| Popis: | Continuous sacral neuromodulation (SNM) is used to treat overactive bladder, reducing urine leakage and increasing capacity. Conditional SNM applies stimulation in response to changing bladder conditions, and is an opportunity to study neuromodulation effects in various disease states. A key advantage of this approach is saving power consumed by stimulation pulses. This study demonstrated feasibility of automatically applying neuromodulation using a wireless bladder pressure sensor, a real-time control algorithm, and the Medtronic Summit™ RC+S neurostimulation research system. This study tested feasibility of four conditional SNM paradigms over five days in 4 female sheep. Primary outcomes assessed proof of concept of closed-loop system function. While the bladder pressure sensor correlated only weakly to simultaneous catheter-based pressure measurement (correlation 0.26-0.89, median r = 0.52), the sensor and algorithm were accurate enough to automatically trigger SNM appropriately. The neurostimulator executed 98.5% of transmitted stimulation commands with a median latency of 72 ms (n = 1,206), suggesting that rapid decision-making and control is feasible with this platform. On average, bladder capacity increased for continuous SNM and algorithm-controlled paradigms. Some animals responded more strongly to conditional SNM, suggesting that treatment could be individualized. Future research in conditional SNM may elucidate the physiologic underpinnings of differential response and enable clinical translation. |
| Databáze: | OpenAIRE |
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