Human spinal cord activation during filling and emptying of the bladder

Kofi A. Agyeman, Darrin J. Lee, Aidin Abedi, Sofia Sakellaridi, Evgeniy I. Kreydin, Jonathan Russin, Yu Tung Lo, Kevin Wu, Wooseong Choi, Sumant Iyer, V. Reggie Edgerton, Charles Y. Liu () and Vassilios N. Christopoulos ()
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Kofi A. Agyeman: University of Southern California
Darrin J. Lee: University of Southern California
Aidin Abedi: University of Southern California
Sofia Sakellaridi: Casa Colina Hospital and Centers for Healthcare
Evgeniy I. Kreydin: University of Southern California
Jonathan Russin: University of Southern California
Yu Tung Lo: University of Southern California
Kevin Wu: University of Southern California
Wooseong Choi: University of Southern California
Sumant Iyer: University of Southern California
V. Reggie Edgerton: University of Southern California
Charles Y. Liu: University of Southern California
Vassilios N. Christopoulos: University of Southern California

Nature Communications, 2025, vol. 16, issue 1, 1-13

Abstract: Abstract The spinal cord is essential for processing sensory information and regulating autonomic functions, such as bladder control, which is critical for urinary continence and voiding. Understanding how the spinal cord represents bladder pressure can provide valuable insights into the neural mechanisms underlying bladder control and contribute to developing better therapies for bladder dysfunction. However, measuring neural activity in the human spinal cord is notoriously challenging due to its small size and the surrounding bony and fascial enclosures, limiting the effectiveness of traditional neuroimaging techniques. Functional ultrasound imaging (fUSI) is a minimally invasive, emerging modality that overcomes these barriers, offering high sensitivity, spatial coverage, and spatiotemporal resolution for studying neural dynamics. Here, we combine fUSI with urodynamically controlled bladder filling and emptying to examine hemodynamic responses in the human spinal cord during one cycle of micturition. Using intravesical bladder pressure recordings, we identify spinal cord regions with hemodynamic signals that strongly correlate with bladder pressure. Furthermore, a linear support vector machine regression model (SVM-r) trained on the fUSI power Doppler signal reveals relevant spinal cord regions and accurately reconstructs bladder pressure changes. Our findings provide evidence of bladder pressure-responsive regions in the spinal cord, where hemodynamic signals strongly correlate with bladder pressure.

Date: 2025
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DOI: 10.1038/s41467-025-61470-1

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