# Neurostimulation for lower motor neuron bowel syndrome due to incomplete lower motor neuron injury

> **NIH VA I21** · DURHAM VA MEDICAL CENTER · 2022 · —

## Abstract

Sacral or cauda equinal injury due to spinal trauma results in lower motor neuron injury neurogenic
bowel disorder (LMNI-NBD). Due to decreased sacral parasympathetic propulsive control of the distal
colonic smooth muscle and pudendal somatomotor control of the external anal sphincter, the storage
and release function of the rectum and anus are disrupted. This results in a hypocontractile bowel and
sphincter, which manifests as constipation and fecal incontinence, with increased frequency of
defecation and incontinence, increased use of oral medications and dietary modifications directed
toward bowel care, and increased time for defecation and use of the Valsalva maneuver when
defecation is the goal. The constellation of symptoms, treatments and behavioral modifications with
lack of effective treatments contribute dramatically to reduction in quality of life for patients with LMNI-
NBD.
We have recently demonstrated the ability to impose control of function in a parallel pelvic storage and
release system, the lower urinary tract, under conditions of incomplete LMNI. Our model was that of
unilateral preganglionic pelvic nerve transection, as might result from pelvic surgery or trauma. In this
model of neurogenic underactive bladder with detrusor underactivity, we demonstrated on-demand
voiding function using proximal outlet (urethra) neural stimulation, activating positive feedback signals
for evacuation. As such mechanisms are known to exist within the anorectal control system, we
hypothesize that this approach may also be employed to treat LMNI-NBD by local electrical stimulation
of anal canal reflex pathways in patients with incomplete LMNI.

## Key facts

- **NIH application ID:** 10368668
- **Project number:** 1I21RX003899-01
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** MATTHEW O FRASER
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10368668

## Citation

> US National Institutes of Health, RePORTER application 10368668, Neurostimulation for lower motor neuron bowel syndrome due to incomplete lower motor neuron injury (1I21RX003899-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10368668. Licensed CC0.

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