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Received July 17, 2006
Revised August 26, 2006
Accepted after revision October 15, 2006
1 Inserm E358, Institut François Magendie; Université Bordeaux 2
2 Université Bordeaux 2, EA2966
3 Inserm E358, Institut François Magendie; Université Bordeaux 2
* To whom correspondence should be addressed. E-mail: frederic.nagy{at}bordeaux.inserm.fr.
Multiple sclerosis (MS) is characterised by inflammatory lesions throughout the central nervous system. Spinal cord inflammation correlates with many neurological deficits. Most MS patients suffer from micturition dysfunction with urinary incontinence and difficulty in emptying the bladder. In experimental autoimmune encephalomyelitis (EAE) induced in female Lewis rats, a model of MS, we investigated at distinct clinical severity scores the micturition reflex by cystometrograms. All rats presenting clinical EAE suffered from micturition reflex alterations with either detrusor areflexia or hyperactivity. Already during preclinical EAE, a majority of rats presented with detrusor areflexia, while at onset of clinical EAE, detrusor hyperactivity was predominant. During clinical EAE progression, detrusor areflexia and hyperactivity were equally expressed. Bladder hyperactivity was suppressed by activation of glycine and GABA receptors (R) in the lumbosacral spinal cord with an order of potency: glycine-R > GABAB-R > GABAA-R. Detrusor areflexia was transformed into detrusor hyperactivity by blocking glycine and GABA receptors. Spinalisation abolished bladder activity in rats presenting detrusor hyperactivity and failed to induce activity in detrusor areflexia. Altogether the results reveal an exaggerated descending excitatory control in both detrusor reflex alterations. In detrusor areflexia, a strong segmental inhibition dominates this excitatory control. Similar to MS treatment, electrical stimulation of sacral roots reduced detrusor hyperactivity in EAE. Blockade of glycine receptors in the lumbosacral spinal cord suppressed the stimulation-induced inhibitory effect. Our data help to better understand bladder dysfunction and treatment mechanisms to suppress detrusor hyperactivity in MS.
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