New Funding for Spinal Cord Injury Work

Congrats to Jim Hokanson - PI and the team on being awarded a new 5-year R01 “Optimization of Chronic Neuromodulation in Treating Neurogenic Bladder Dysfunction”. In collaboration with our lab and Philipp Gutruf, we will be developing technology and a knowledge base to better understand how tibial nerve stimulation (TNS) improves bladder function following spinal cord injury.

Abstract: Lower urinary tract dysfunction is a significant impairment for individuals with spinal cord injury (SCI), and tibial nerve stimulation (TNS) shows promise in enhancing bladder function in this population. However, key questions remain regarding the impact of TNS dosing variables (including dosing duration, intra-dose duration, and time between doses), the timing of interventions in relation to injury, and the long-term effectiveness of chronic TNS application. Testing these approaches in humans is difficult due to patient heterogeneity and variable compliance. As such, TNS studies in humans tend to focus solely on the efficacy of a single approach rather than optimizing or testing different approaches. Pre-clinically, existing research primarily involves acute stimulation in healthy animal models, which limits insights applicable to chronic clinical settings. To address these gaps, this proposal aims to utilize a novel wireless tibial nerve stimulator to explore unanswered questions about TNS therapy for neurogenic bladder disorders. The investigation will focus on three main aims: 1) evaluating the influence of TNS dosing on functional bladder recovery post-SCI, assessing the effects of varying dosing intervals and durations; 2) assessing the optimal timing for TNS intervention during different recovery phases of SCI to enhance therapeutic efficacy; and 3) evaluating how chronic TNS dosing duration influences efficacy in a rat model of SCI. These studies aim to clarify TNS stimulation parameters and improve therapeutic outcomes, which is integral information for ultimately informing future clinical trials and improving care for patients with neurogenic bladder disorders.