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Publication Detail
Design of a wearable device for conditional neuromodulation of the pudendal nerve
  • Publication Type:
    Thesis/Dissertation
  • Authors:
    Nasrollahy Shiraz A
  • Supervisors:
    Demosthenous A
  • Status:
    Unpublished
  • Language:
    English
  • Keywords:
    Pudendal nerve neuromodulation, Hybrid model, SEMG from EAS, Volume conductor model, Nerve model, Medical devices
Abstract
After spinal cord injury, the normal functions of the lower urinary tract may be disrupted. Namely, incontinence and concurrent voiding problems may ensue. The troublesome side effects of the drugs, infection due to catheterisation, and the costs and risks associated with more invasive treatments indicate the need for alternative forms of treatment. The pudendal nerve neuromodulation may provide such an alternative. The unique aspect of this technique is that depending on the stimulus frequency it may result in micturition-like or continence-like reflexes. Also, the stimulus current can be applied trans-rectally, meaning that a minimally-invasive wearable solution may be developed. The major limitation of such a solution is the high level of the required stimulus current to activate the nerve trans-rectally. The efficacy of the trans-rectal neuromodulation of the pudendal may be increased by only applying the stimulus when needed, when employed to tackle incontinence. The electromyogram signal from the external anal sphincter may be used to detect the onset of hyper-reflexive contractions of the bladder. The ability of recording this signal can be readily incorporated in the neuromodulation device due to the proximity of the structures. However, the recording electrodes should be designed for an efficacious and chronic recording. Thus, the main objective of this thesis was to design and optimise the neuromodulation and recording electrodes on the said device. A volume conductor model of such a device in situ was developed and used in tandem with a double layer cable model of nerve fibres to minimise the stimulus current. It was demonstrated that a considerable reduction in the stimulus current may be achieved even when the variations of the nerve trajectory in different individuals are considered. Using computational models and experimental measurements, a recording assembly was identified for an efficacious recording of the electromyogram from the external anal sphincter.
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