Innovative Imaging Reveals Spinal Cord's Role in Bladder Control

A groundbreaking study by researchers from USC has uncovered new insights into how the human spinal cord regulates bladder function. Utilizing advanced functional ultrasound imaging (fUSI), the team was able to observe real-time changes in blood flow within the spinal cord during bladder filling and emptying. This research marks a significant step forward in understanding the neural mechanisms underlying urinary incontinence, a condition affecting over 33 million Americans and impacting mental health and quality of life.

The study was led by Dr. Charles Liu from the USC Neurorestoration Center and Professor Vasileios Christopoulos of USC's biomedical engineering department. The collaborative effort also included postdoctoral scholars Kofi Agyeman and Darrin Lee, along with Evgeniy Kreydin from Rancho Los Amigos National Rehabilitation Center. The researchers overcame traditional barriers to studying the spinal cord—such as its small size and encasement in bone—by leveraging a unique opportunity during epidural spinal cord stimulation surgeries. During these procedures, a temporary 'window' into the spinal cord was created, allowing for safe and minimally invasive imaging.

Using fUSI, the team observed specific areas in the spinal cord whose activity correlated directly with bladder pressure. Some regions showed increased activity with rising pressure (positive correlation), while others decreased in activity (negative correlation). This indicated the presence of both excitatory and inhibitory neural networks involved in bladder regulation. These findings provide a new understanding of the spinal cord's functional networks, which had previously been difficult to study in living humans.

The implications of this research are profound. By decoding bladder pressure from spinal cord activity, the study offers hope for developing personalized neuromodulation therapies. Such treatments could alert patients about their bladder state or improve control via targeted spinal cord interfaces. Since current interventions focus mainly on the lower urinary tract and lack a complete understanding of the neural basis, this research paves the way for more precise, effective approaches.

This breakthrough also highlights the potential of fUSI technology—not only as a diagnostic tool but as a bridge to innovative treatments for neurogenic bladder dysfunction. Ultimately, understanding and manipulating spinal cord activity could restore vital functions like bladder, bowel, and sexual control, vastly improving patients' quality of life.