You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Basic Research II1 Apr 20121008 SACRAL NEUROSTIMULATION (SNS) IN A RODENT MODEL: EFFECTS OF NERVE LOCATION AND PULSE PARAMETERS ON SYNAPTIC ELEMENTS OF A SEXUAL RESPONSE SPINAL CIRCUIT Richard Johnson, Sunny Ferrero, and Victoria Dugan Richard JohnsonRichard Johnson Gainesville, FL More articles by this author , Sunny FerreroSunny Ferrero Gainesville, FL More articles by this author , and Victoria DuganVictoria Dugan Gainesville, FL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1110AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Electrical neurostimulation of human sacral spinal nerves (SNS) is used to treat overactive bladder. SNS also activates axons involved in sexual function and recent clinical studies document a potential benefit on sexual outcomes. A rat model was developed to investigate neurostimulation (NS) nerve sites and pulse parameters. We evaluated the NS effects on a spinal reflex circuit involved in sexual response. The pudendal motoneuron reflex discharge (PMRD) has been previously described in males as a sensitive measure of the spinal circuit integrity for ejaculation (e.g. chronic spinal cord injury, premature ejaculation) and in females to assess treatments for bladder control. The PMRD is triggered by the dorsal nerve of the penis (DNP). Elimination of any of the penile sensory, spinal cord, or pudendal motor limbs of this reflex prevents the occurrence of ejaculation and sensations of orgasm. METHODS In anesthetized male rats, the magnitude of the DNP-elicited PMRD test response on the right side of the animal was quantitated by recording reflex-evoked action potentials in pudendal motor axons elicited by penile afferent activation. The central spinal effects of NS applied to multiple nerves on the left side was evaluated by quantifying the contralateral synaptic modulation of the right-sided PMRD in this bilateral circuit. NS periods of 20 sec to 5 min were induced over a wide range of frequencies (1- 50 Hz) and pulse configurations. RESULTS Results were (i) a frequency-dependent (maximum at 20-25 Hz) but mostly transient (initial 20 sec) depression of PMRD magnitude occurred during NS of the DNP, compound pudendal nerve, and L6 spinal nerve but not during NS of the superficial perineal nerve or the S1 spinal nerve, and (ii) the reflex depression was significantly less when only large diameter afferents were stimulated (biphasic NS pulse widths of 0.01-0.02 ms) compared to when large and small diameter afferents are stimulated (pulse widths of 0.5 ms) particularly when the current intensity was set near 1.0 times reflex threshold. CONCLUSIONS We conclude that the NS at certain targets and parameters, can induce transient depression of the PMRD. The PMRD depression is elicited only when nerves containing DNP afferents are stimulated. The depression is frequency dependent and minimized when only large diameter myelinated afferents are stimulated using short duration pulses and low current intensity. The nerve site and parameter differences may explain the high variability in NS-induced sexual response effects in patients. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e410 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Richard Johnson Gainesville, FL More articles by this author Sunny Ferrero Gainesville, FL More articles by this author Victoria Dugan Gainesville, FL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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