# Effects of activity dependent plasticity on recovery of bladder and sexual function after human spinal cord injury

> **NIH NIH R01** · UNIVERSITY OF LOUISVILLE · 2020 · $381,600

## Abstract

Abstract
Bladder and bowel complications have consistently been rated as of the upmost importance by
the spinal cord injury (SCI) population. Importantly, both bladder and bowel distention have
been identified as primary triggers of autonomic dysreflexia (AD) in individuals with cervical and
upper thoracic level lesions (majority of SCI population), a systolic blood pressure rising often
more than 20 mmHg and remaining at these values with intolerable symptoms (pounding
headache and/or chills, for example). We have recently documented as part of our current R01
this massive unmodulated sympathetic reflex which causes widespread vasoconstriction
(presenting as severe hypertension) as a limitation for bladder capacity in numerous research
participants. Anecdotally, many who use clean intermittent catheterization for bladder
management report using AD symptoms daily as a signal of bladder fullness and time for
emptying, an unsafe practice that needs addressing. Additionally, we and others have
documented in questionnaires regular occurrences of AD symptoms during bowel programs and
in ongoing lab-based studies there have been numerous instances of AD upon insertion of a
rectal probe either for bladder cystometry (for recording abdominal pressure) or during anorectal
manometry. The goals of the current multi-disciplinary study incorporating critical cross viscero-
visceral intersystem interactions are 1) to investigate in a controlled laboratory setting and then
with mobile at-home monitoring the extent, severity and frequency of occurrence of AD with
respect to daily bladder and bowel function, in conjunction with identifying potential underlying
mechanisms by examining urinary biomarkers for several specific vasoactive hormones, and 2)
to regulate cardiovascular (CV) function therapeutically as part of bladder and bowel
management using spinal cord epidural stimulation, which our CV team have shown can
normalize blood pressure.

## Key facts

- **NIH application ID:** 9969878
- **Project number:** 2R01HD080205-06
- **Recipient organization:** UNIVERSITY OF LOUISVILLE
- **Principal Investigator:** SUSAN J HARKEMA
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $381,600
- **Award type:** 2
- **Project period:** 2014-09-23 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9969878

## Citation

> US National Institutes of Health, RePORTER application 9969878, Effects of activity dependent plasticity on recovery of bladder and sexual function after human spinal cord injury (2R01HD080205-06). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9969878. Licensed CC0.

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