Wireless, Closed?loop System to Restore Urological Dysfunction after Spinal Cord Injury - PROJECT SUMMARY Many (>70%) individuals that suffer a severe, high-level spinal cord injury (SCI) develop bladder detrusor sphincter dyssynergia (DSD). A substantial number of these individuals will develop serious urological complications such as urinary tract infection, renal reflux effect, or renal failure. Current treatments are limited and the complications rates can be significant using stent implantations or other surgical procedures. Thus, development of new tools/therapies that help stimulate more reliable/efficient bladder emptying could significantly improve quality of life and the overall health of SCI patients. The overall objective of the project is to develop a wireless, battery-free implant capable of supporting artificial intelligence (AI) algorithm for autonomous closed-loop neuromodulation (CL-NM) management of DSD after SCI. We will fabricate and validate a wireless, battery-free bioelectronic implant that allows continuous, long-term monitoring and autonomous electrical stimulation through a closed-loop AI system. We will also demonstrate closed-loop neuromodulation (CL-NM) treatment of detrusor sphincter dyssynergia (DSD) in rat SCI model. The soft stretchable electrodes with high charge injection capability will be able to stimulate the acute and sub-acute bladder wall to induce detrusor contraction, while simultaneously fatiguing the EUS and PFMs to reduce outflow resistance. Such a combination effect will result in a near normal voiding process. The proposed bioelectronic system will have broad clinical utility in monitoring and modulating bladder function, and provide a new treatment method together with closed- loop technologies for patients with severe DSD that do not respond to traditional therapies. This technology platform can also be easily adapted to address a range of application possibilities beyond those associated with the bladder. It will have significant impact in field of Rehabilitation and regeneration after SCI.
