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Effects of non-invasive spinal cord stimulation on lower urinary tract, bowel, and sexual functions in individuals with chronic motor-complete spinal cord injury: Protocol for a pilot clinical trial

Title: Effects of non-invasive spinal cord stimulation on lower urinary tract, bowel, and sexual functions in individuals with chronic motor-complete spinal cord injury: Protocol for a pilot clinical trial
Authors: Samejima, Soshi; Shackleton, Claire; McCracken, Laura; Malik, Raza N.; Miller, Tiev; Kavanagh, Alex; Ghuman, Amandeep; Elliott, Stacy; Walter, Matthias; Nightingale, Tom E.; Berger, Michael J.; Lam, Tania; Sachdeva, Rahul; Krassioukov, Andrei V.
Contributors: Carels, Vanessa; International Spinal Research Trust; Praxis Spinal Cord Institute; Canadian Foundation of Innovation; British Columbia Knowledge Development Fund
Source: PLOS ONE ; volume 17, issue 12, page e0278425 ; ISSN 1932-6203
Publisher Information: Public Library of Science (PLoS)
Publication Year: 2022
Collection: PLOS Publications (via CrossRef)
Description: Introduction Electrical spinal cord neuromodulation has emerged as a leading intervention for restoring autonomic functions, such as blood pressure, lower urinary tract (LUT), bowel, and sexual functions, following spinal cord injury (SCI). While a few preliminary studies have shown the potential effect of non-invasive transcutaneous spinal cord stimulation (tSCS) on autonomic recovery following SCI, the optimal stimulation parameters, as well as real-time and long-term functional benefits of tSCS are understudied. This trial entitled “Non-invasive Neuromodulation to Treat Bladder, Bowel, and Sexual Dysfunction following Spinal Cord Injury” is a pilot trial to examine the feasibility, dosage effect and safety of tSCS on pelvic organ function for future large-scale randomized controlled trials. Methods and analysis Forty eligible participants with chronic cervical or upper thoracic motor-complete SCI will undergo stimulation mapping and assessment batteries to determine the real-time effect of tSCS on autonomic functions. Thereafter, participants will be randomly assigned to either moderate or intensive tSCS groups to test the dosage effect of long-term stimulation on autonomic parameters. Participants in each group will receive 60 minutes of tSCS per session either twice (moderate) or five (intensive) times per week, over a period of six weeks. Outcome measures include: (a) changes in bladder capacity through urodynamic studies during real-time and after long-term tSCS, and (b) resting anorectal pressure determined via anorectal manometry during real-time tSCS. We also measure assessments of sexual function, neurological impairments, and health-related quality of life using validated questionnaires and semi-structured interviews. Ethics and dissemination Ethical approval has been obtained (CREB H20-01163). All primary and secondary outcome data will be submitted to peer-reviewed journals and disseminated among the broader scientific community and stakeholders.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1371/journal.pone.0278425
Availability: https://doi.org/10.1371/journal.pone.0278425; https://dx.plos.org/10.1371/journal.pone.0278425
Rights: http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.3D117C01
Database: BASE