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Central inhibitory effect of intravesically applied botulinum toxin A in chronic spinal cord injury

✍ Scribed by Alvaro Munoz; George T. Somogyi; Timothy B. Boone; Christopher P. Smith


Publisher
John Wiley and Sons
Year
2011
Tongue
English
Weight
601 KB
Volume
30
Category
Article
ISSN
0733-2467

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✦ Synopsis


Abstract

Aims

We evaluated a putative central inhibitory effect of intravesical botulinum toxin A (BoNT‐A) on the activity of lumbosacral spinal neurons in a chronic spinal cord injury (SCI) model of bladder overactivity.

Methods

Female Sprague‐Dawley rats underwent T8 spinal cord transection. Four weeks later, once overactive neuropathic detrusor pathways had developed, the animals underwent intravesical instillation with either saline (1 ml) or BoNT‐A (Botox®, 20 U/1 ml) for 1 hr. Two days later, the rats then completed a cystometric evaluation prior to spinal cord harvest. Sections from the L4‐S1 spinal cord segments were examined for the total number of c‐fos immunoreactive cells.

Results

Comparison of the saline and BoNT‐A treated groups showed a significant decrease in L6 (i.e., 67%, P < 0.001) and S1 (i.e., 47%, P < 0.01) c‐fos expression (43%) in BoNT‐A treated rats compared to saline controls. Cystometrogram studies revealed that the frequency of non‐voiding bladder contractions was reduced by 73% (P < 0.05) in BoNT‐A compared to saline treated rats. No change in the frequency of voiding bladder contractions or amplitude of bladder contraction was observed between the saline and BoNT‐A treated groups.

Conclusion

In a SCI model of bladder overactivity, intravesical BoNT‐A significantly inhibits the response of bladder afferent activated lumbosacral neurons without significantly impairing efferent bladder function. Neurourol. Urodynam. 30:1376–1381, 2011. © 2011 Wiley‐Liss, Inc.