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Prototype Deep Brain Stimulation System with Closed-Loop Control Feedback for Modulating Bladder Functions in Traumatic Brain Injured Animals

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Abstract

Traumatic brain injury (TBI) typically causes permanent brain tissue damage, which leads to permanent severe voiding dysfunction. Urinary retention is often refractory to standard therapies, and most patients require self-catheterization, which results in frequent urinary tract infections and reduces quality of life. Deep brain stimulation (DBS) might be a feasible alternative approach for treating bladder disorders in patients with TBI. In this study, we developed a DBS system with a closed-loop control strategy and determined the feasibility of this DBS system for improving bladder voiding function in a TBI animal model. A prototype of the DBS system was designed, fabricated and integrated with a closed-loop control algorithm based on the real-time external urethral sphincter-electromyogram feedback. A series of animal experiments was conducted to determine whether the feedback algorithm accurately detects the bladder status during cystometric measurements. Subsequent animal experiments were conducted to implement this DBS system and determine the performance of the closed-loop strategy for improving bladder functions in the TBI animal model. We successfully implemented a closed-loop algorithm for DBS control, and the accuracy of the bladder voiding phase detection was > 90%. Our system significantly improved the voiding efficiency in TBI rats from 22 to 74%. Although the prototype of the DBS feedback system was fabricated with surface-mounted device components and mounted on a 3D printed circuit board, the design principles and animal experience gathered from this research can serve as a basis for developing a new implantable bladder controller in the future.

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Acknowledgements

This study was supported by grants from the Ministry of Science and Technology (MOST106-2221-E-038-010-MY3, MOST103-2221-E-038-007-MY3, and NSC 102-2320-B-002-040 -MY2) and by the R&D Foundation of Urological Medicine, Taiwan. The authors also thank Professors Te-Son Kuo and Shuenn-Tsong Young for their outstanding technical support.

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Authors and Affiliations

  1. Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, 106, Taiwan

    En Jen & Chii-Wann Lin

  2. School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, 250 Wuxing Street, Taipei, 11031, Taiwan

    En Jen & Chih-Wei Peng

  3. Institute of Biomedical Engineering, National Taiwan University, Taipei, 106, Taiwan

    Chii-Wann Lin, Tsung-Che Lu & Meng-Chao Chen

  4. Department of Electrical Engineering, National Taiwan University, Taipei, 106, Taiwan

    Chii-Wann Lin

  5. Department of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan

    Tsung-Hsun Hsieh

  6. Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, 333, Taiwan

    Tsung-Hsun Hsieh

  7. Graduate Institute of Neural Regenerative Medicine, Taipei Medical University, Taipei, 110, Taiwan

    Tsung-Hsun Hsieh

  8. Urology Department, Zhongxiao Branch, Taipei City Hospital, Taipei, 115, Taiwan

    Yi-Chun Chiu

  9. School of Medicine, National Yang-Ming University, Taipei, 112, Taiwan

    Yi-Chun Chiu

  10. Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 110, Taiwan

    Shih-Ching Chen & Chih-Wei Peng

  11. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, 110, Taiwan

    Shih-Ching Chen & Chih-Wei Peng

  12. Department of Neurosurgery, China Medical University Hospital, Taipei, 114, Taiwan

    Meng-Chao Chen

  13. International Ph.D. Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, 110, Taiwan

    Chih-Wei Peng

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  1. En Jen
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Correspondence to Chih-Wei Peng.

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Jen, E., Lin, CW., Hsieh, TH. et al. Prototype Deep Brain Stimulation System with Closed-Loop Control Feedback for Modulating Bladder Functions in Traumatic Brain Injured Animals. J. Med. Biol. Eng. 38, 337–349 (2018). https://doi.org/10.1007/s40846-017-0326-1

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  • DOI: https://doi.org/10.1007/s40846-017-0326-1

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