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Nerve transfer for restoration of lower motor neuron-lesioned bladder, urethral and anal sphincter function. Part 4: Effectiveness of the motor reinnervation
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2024-03
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Aging and Cardiovascular Discovery Center
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Filename: Data for Tiwari et al 2024_AJP_03-21-2024.xlsx Short description: An excel file is provided that includes the raw data for analyses for Figures 1-8. Each tab includes the data from each different figure. B. Filename: Supplemental Videos for Tiwari et al 2024_AJP_03-21-2024.docx Short description: Representative images and videos showing recovery of squat-and-void postures at the Final testing point for Tiwari et al 2024_AJP. Representative images and videos showing recovery of squat-and-void postures at the Final testing point. Slide 1) Images of a squat-and-void posture in the home cage of one ObNT-ScNT Reinn animal before decentralization (PreSurgery) and a video collected at 14 months after onset of the experiment (1 year after decentralization and 4 months after reinnervation surgery). Slide 2) Images of a squat-and-void posture in the home cage of a second ObNT-ScNT Reinn animal before decentralization (PreSurgery) and a video collected at 14 months after onset of the experiment (1 year after decentralization and 4 months after reinnervation surgery). Slide 3) Videos of a third ObNT-ScNT Reinn animal at 6, 7 and 9 months after the reinnervation surgery. These videos were collected during awake bladder filling sessions (i.e., awake urodynamics).
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http://dx.doi.org/10.34944/dspace/9955
Abstract
The original design and necessary modifications of the project plan are as described in part 1 of this series (26). The current study is part 4 of a series reports and results from 30 animals with three main groups (Fig. 1A). The ObNT-ScNT Reinn group consisted of 8 dogs that were in the study a total of 22 months (22 ± 0.4 mo, mean ± SEM, Fig. 1B). At study onset, these ObNT-ScNT Reinn animals functionally decentralized by bilaterally transecting the dorsal roots of L7, all spinal roots caudal to L7, and the hypogastric nerves, followed by a 9-13 mo recovery period (10.4 ± 0.7 mo, Fig. 1C), then reinnervation by transfer of the obturator nerve to the vesical branch of the pelvic nerve, as well as a branch of the sciatic nerve to the pudendal nerve, that was then followed by an additional 8-12 mo recovery (11.9 ± 0.4 mo, Fig. 1C). The Decentralized group consisted of 4 animals that underwent similar decentralization followed by an 11-21 mo recovery (18 ± 2.5 mo, Fig. 1B), but no reinnervation surgeries. Controls consists of 7 sham-operated and 11 unoperated animals (18 total; Fig. 1A).
Description
The original design and necessary modifications of the project plan are as described in part 1 of this series (26). The current study is part 4 of a series reports and results from 30 animals with three main groups (Fig. 1A). The ObNT-ScNT Reinn group consisted of 8 dogs that were in the study a total of 22 months (22 ± 0.4 mo, mean ± SEM, Fig. 1B). At study onset, these ObNT-ScNT Reinn animals functionally decentralized by bilaterally transecting the dorsal roots of L7, all spinal roots caudal to L7, and the hypogastric nerves, followed by a 9-13 mo recovery period (10.4 ± 0.7 mo, Fig. 1C), then reinnervation by transfer of the obturator nerve to the vesical branch of the pelvic nerve, as well as a branch of the sciatic nerve to the pudendal nerve, that was then followed by an additional 8-12 mo recovery (11.9 ± 0.4 mo, Fig. 1C). The Decentralized group consisted of 4 animals that underwent similar decentralization followed by an 11-21 mo recovery (18 ± 2.5 mo, Fig. 1B), but no reinnervation surgeries. Controls consists of 7 sham-operated and 11 unoperated animals (18 total; Fig. 1A).
There is some overlap with the pilot study (22) and part 2 (25) of this series. Specifically, we included squat-and-void posture data from 3 ObNT-ScNT Reinn animals, 1 Decentralized animal, and 8 Control animals (5 sham-operated and 3 sham-unoperated) from the small pilot study, and in vivo electrophysiology data for peripheral nerve-evoked bladder, urethra and anal sphincter contractility from 3 ObNT-ScNT Reinn animals from the pilot study (22). We also included the in vivo peripheral nerve-evoked bladder contractility graph from Part 2 of this series (25) for comparison purposes to new additional data.
Unique to this manuscript are: 1) data from 18 additional animals, 2) report of defecation postures; 3) segmental spinal root/cord-evoked bladder, urethra and anal sphincter contractility data from all animals from L2-S3 to more closely match reports that spinal cord input to the obturator nerve is nearer to L3-L6 (20, 27-29); 4) peripheral nerve-evoked urethra and anal sphincter contractility data from the Decentralized and Control animals, and 5 additional ObNT-ScNT Reinn animals; 5) retrograde dye labeling data in the spinal cord ventral horn segments from L2-S3 after dye injections into the bladder and urethra sphincter; 6) Rexed laminar location of these labeled neurons in the spinal cord; and 7) correlations between these various outcomes. Because of the inclusion of the urethral and anal sphincter data, we renamed the reinnervated group to ObNT-ScNT Reinn (different from prior studies in which we focused on the obturator nerve transfer to the pelvic nerve results, and thus named the reinnervated group as “ObNT-Reinn”).
Citation
In Press. Barbe, MF et al. Nerve transfer for restoration of lower motor neuron-lesioned bladder, urethral and anal sphincter function. Part 4: Effectiveness of the motor reinnervation American Journal of Physiology- Regulatory, Integrative, and Comparative Physiology.
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