New treatments for pelvic floor disorders offer improved quality of life for sufferers
Researchers in Dublin have created an experimental model of neuromodulation to explore treatment and management of pelvic floor disorders to improve quality of life for sufferers.
Faecal incontinence is a physically, and emotionally, debilitating condition which affects around 2 % of the UK population on a daily or weekly basis. It describes the condition where an individual loses control over the passing of faeces from the rectum; this can be a result of degeneration of the anal sphincter, spinal injury, child birth or a range of neurological disorders. Neuromodulation is an important and developing area of research crucial to identifying treatment and management for pelvic floor disorders such as faecal incontinence.
Previous experimental models of neuropathic faecal incontinence have confirmed that pelvic side-wall compression (used to simulate childbirth) affects both motor efferent and sensory afferent pathways. It has also been demonstrated that in some individuals it is possible to alter sphincter and proximal bowel behaviour by stimulating the surrounding nerves and muscles. A recent study by James Jones and colleagues, published in the British Journal of Surgery aimed to build on previous studies and establish whether sensory activation of the cerebral cortex by anal canal stimulation was increased by peripheral neuromodulation.
The team of researchers used MultiChannel Systems ME-16 In Vivo recording system to record from the right primary somatosensory cortex of anesthetized rats, measuring the characteristics of action potentials evoked by simulating the anal canal. They then observed how the action potentials were augmented by sacral nerve stimulation and posterior tibial nerve stimulation. Each type of peripheral nerve stimulation elicited a significantly increased peak amplitude in action potentials within the somatosensory cortex. They also revealed the density of PSA-NCAM -positive cells (polysiolylated neuronal cell adhesion molecule) within the cortex underlying the electrode array was increased by approximately 50%.
This study offers important information which will help in determining the design and programming of neuromodulation devices for managing the symptoms of pelvic floor disorders. For further information on this study please see:
Sacral nerve stimulation increases activation of the primary somatosensory cortex by anal canal stimulation in an experimental model K.M. Griffin, M. Pickering, C. O'Herlihy, P.R. O'Connell and J. F. X. Jones
British Journal of Surgery 2011; 98:1160-1169
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