Restoring significant bladder control to 5 men with spinal cord injuries

Magnetic stimulation of the lower spine eliminates the need for a catheter for up to 4 weeks.

UCLA neuroscientists, led by Dr. Daniel Lu, stimulated the lower spinal cord through the skin with a magnetic device placed at the lumbar spine.
UCLA neuroscientists, led by Dr. Daniel Lu, stimulated the lower spinal cord through the skin with a magnetic device placed at the lumbar spine.

In an investigation of five men whose injuries happened five to 13 years back, UCLA neuroscientists empowered the lower spinal cord through the skin with a magnetic device set at the lumbar spine. The exploration is the first to demonstrate that the system empowers individuals with spinal cord injuries to recover significant bladder control for up to a month between treatments.

The treatment enhanced the men’s quality of life by a normal of 60 percent (as per a survey they finished when the investigation). Furthermore, if the method is replicable on other individuals, it could help diminish the social stigma and health risks connected to frequent catheter use.

Dr. Daniel Lu, the study’s principal investigator said, “We were excited to see a positive effect in all five patients after only four sessions of mild magnetic stimulation. The benefit persisted from two to four weeks, suggesting that the spinal cord’s neural circuitry retains a ‘memory’ of the treatment.”

“Most spinal cord injuries are not anatomically complete; the spinal cord retains a weak, residual connection with the brain. We are restoring bladder function by amplifying these faint signals and enhancing the neural circuits’ ability to respond to them.”

Scientists applied magnetic stimulation to the spinal cord to access the cellular machinery controlling urination. Doctors previously have used the same approach with the brain to improve nerve cell function for conditions ranging from depression to a migraine.

Each participant underwent 15 minutes of weekly stimulation for four months. At first, the scientists saw no results. But after four sessions, the men began to experience measurable improvement.

Lu said, “All five of the men regained the ability to urinate on their own during stimulation. One patient — 13 years after his injury — was able to completely stop using a catheter and empty his bladder several times a day, up to four weeks after his last treatment.”

“Four of the men still had to use a catheter at least once each day — but that was still a significant drop from their average of more than six times a day before the treatment.”

The patients’ average bladder limit expanded from 244 millimeters to 404 millimeters, and the volume of urine they produce willfully ascended from 0 to 1120 cubic centimeters for every day.

The experiment built upon Lu’s earlier research, in which he surgically implanted electrical stimulation devices in the spine to improve hand control in two people with cervical spinal cord injuries. While the concept for the new study is similar, Lu’s team used magnetic stimulation because it’s noninvasive, painless and less costly than an electrical implant.

Lu and his colleagues plan to evaluate the approach with a larger number of men and women in a second study to gain a deeper understanding of how magnetic stimulation alters neural activity in the spinal cord. The team will also explore whether different stimulation patterns improve responses in patients who didn’t benefit to the same degree as others in the study.

The magnetic stimulation device is FDA-approved for use in humans; however, its application for bladder rehabilitation is experimental.

Other co-authors of the study include Dr. Tianyi Niu, Dr. J.C. Leiter, Dr. Carol Bennett and Tina Keller, all of UCLA. The findings are published today in Scientific Reports.