Multi-system neuroprosthetic training improves bladder function after severe spinal cord injury

: BACKGROUND: Severe spinal cord injury (SCI) leads to neurogenic bladder dysfunction. We recently developeda multi-system neuroprosthetic training program (MSNT) that promotes plastic changes capable of restoring refinedlocomotion in rats with severe SCI. We investigated whether MSNTinfluences the formation of posttraumatic bladder dysfunction. MATERIALS AND METHODS: Adult rats were randomly assigned to a SCI (n=8) and to a control intact (n=4) group. SCI consisted of two opposite lateral hemisections (T7, T11), thusinterrupting all direct supraspinal input. After SCI, 4 rats were subjected to MSNT, 4 rats were non-trained. After 8 weekswe performed urodynamics and evaluated kidney function (creatinine, cystatin C). Bladder investigation included morphological, histological and immunohistochemical evaluations. RESULTS: Bladder capacity increased 3-fold in trained and 7-fold in non-trained compared to intact animals. During filling,we found 2.7 ± 1.1 non-voiding contractions (NVC) in trained, compared to 12.6 ± 5.2 in non-trained rats. Bladder morphology was similar in trained and intact rats, non-trained ratsexhibited detrusor hypertrophycharacterized by increased detrusor thickness and decreased connective tissue to smooth muscle ratio. The general nerve density, labeled with PGP9.5, was significantly increased in trained and significantly decreased in non-trained rats. The relative proportion of NF200-postive afferent nerves was significantly lower in trained compared to intact and non-trained rats. NPY-positive fibers showed a significantly lower density in non-trained rats. CONCLUSIONS: MSNT effectively counteracts the formation of neurogenic bladder dysfunction after severe SCI and might contribute to preserving bladder function and preventing long-term complications in patients with severe SCI. ABSTRACT Background : Severe spinal cord injury (SCI) leads to neuro genic bladder dysfunction. We recently developeda multi-system neuroprosthetic training program (MSNT) that promotes plastic changes capable of restoring refinedlocomotion in rats with severe SCI. We investigated whether MSNTinfluences the formation of posttraumatic bladder dysfunction. Materials and Methods: Adult rats were randomly assigned to a SCI (n=8) and to a control intact (n=4) group. SCI consisted of two opposite lateral hemisections (T7, T11), thusinterrupting all direct supraspinal input. After SCI, 4 rats were subjected to MSNT, 4 rats were non-trained. After 8 weekswe performed urodynamics and evaluated kidney function (creatinine, cystatin C). Bladder investigation included morphological, histological and immunohistochemical evaluations. Results: Bladder capacity increased 3-fold in trained and 7-fold in non-trained compared to intact animals. During filling,we found 2.7 ± 1.1 non-voiding contractions (NVC) in trained, compared to 12.6 ± 5.2 in non-trained rats. Bladder morphology was similar in trained and intact rats, non-trained ratsexhibited detrusor hypertrophycharacterized by increased detrusor thickness and decreased connective tissue to smooth muscle ratio. The general nerve density, labeled with PGP9.5, was significantly increased in trained and significantly decreased in non-trained rats. The relative proportion of NF200-postive afferent nerves was significantly lower in trained compared to intact and non-trained rats. NPY-positive fibers showed a significantly lower density in non-trained rats. Conclusions: MSNT effectively counteracts the formation of neurogenic bladder dysfunction after severe SCI and might contribute to preserving bladder function and preventing long-term complications in patients with severe SCI.