Publications by authors named "Lance Zirpel"
Overactive bladder patients suffer from a frequent, uncontrollable urge to urinate, which can lead to a poor quality of life. We aim to improve open-loop sacral neuromodulation therapy by developing a conditional stimulation paradigm using neural recordings from dorsal root ganglia (DRG) as sensory feedback. Experiments were performed in 5 anesthetized felines.
View Article and Find Full Text PDFFeasibility of Real-Time Conditional Sacral Neuromodulation Using Wireless Bladder Pressure Sensor.
IEEE Trans Neural Syst Rehabil Eng
October 2021
Article Synopsis
- Continuous sacral neuromodulation (SNM) effectively treats overactive bladder by reducing leakage and increasing storage capacity, while conditional SNM adapts stimulation based on bladder conditions.
- A study using a wireless bladder pressure sensor and the Medtronic Summit RC+S system tested four conditional SNM methods over five days on four female sheep, aiming to prove the effectiveness of a closed-loop system.
- Results showed that the neurostimulator successfully executed stimulation commands rapidly, and while there was weak correlation with catheter-based pressure measurements, the system could still accurately trigger SNM, indicating potential for personalized treatment in future human applications.
Article Synopsis
- The study aims to assess how different sub-sensory amplitude settings of sacral neuromodulation therapy affect overactive bladder symptoms in individuals with urinary urge incontinence.
- Participants were divided into three groups based on amplitude settings and filled out various questionnaires to track changes in urinary symptoms and quality of life over 12 weeks.
- Results showed significant reductions in urinary incontinence episodes for all groups, with improvements in quality of life and overall bladder condition, highlighting potential benefits of personalized therapy settings for better patient comfort and device longevity.
Aim: Sacral neuromodulation (SNM) is a widely adopted treatment for overactive bladder, non-obstructive urinary retention and faecal incontinence. In the majority, it provides sustained clinical benefit. However, it is recognized that, even for these patients, stimulation parameters (such as amplitude, electrode configuration, frequency and pulse width) may vary at both initial device programming and at reprogramming, the latter often being required to optimize effectiveness.
View Article and Find Full Text PDFObjective: To integrate our functional knowledge in neurorehabilitation with a greater understanding of commonly held theories and current research in neuroplasticity.
Design: Literature review.
Setting: Not applicable.
During the development and maturation of sensory neurons, afferent activity is required for normal maintenance. There exists a developmental window of time when auditory neurons, including neurons of the anteroventral cochlear nucleus (AVCN), depend on afferent input for survival. This period of time is often referred to as a critical period.
View Article and Find Full Text PDFAt maturity, the AMPA receptors of auditory neurons exhibit very rapid desensitization kinetics and high permeability to calcium, reflecting the predominance of GluR3 flop and GluR4 flop subunits and the paucity of GluR2. We used mRNA analysis and immunoblotting to contrast the development of AMPA receptor structure in the chick cochlear nucleus [nucleus magnocellularis (NM)] with that of the slowly desensitizing and calcium-impermeable AMPA receptors of brainstem motor neurons in the nucleus of the glossopharyngeal/vagal nerves. The relative abundance of transcripts for GluRs 1-4 changes substantially in auditory (but not motor) neurons after embryonic day (E)10, with large decreases in GluR2 and increases in GluR3 and GluR4.
View Article and Find Full Text PDF