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Precise control of tibial nerve stimulation for bladder regulation via evoked compound action potential feedback mechanisms

Author

Listed:
  • Young-Soo Lim

    (Pohang University of Science and Technology (POSTECH))

  • Ji Hong Kim

    (Hanyang University)

  • Junho Kim

    (Pohang University of Science and Technology (POSTECH))

  • MinhDuc Hoang

    (Pohang University of Science and Technology (POSTECH))

  • Wonok Kang

    (Pohang University of Science and Technology (POSTECH)
    Yeungnam University)

  • Mattew Koh

    (Pohang University of Science and Technology (POSTECH))

  • Won Hyuk Choi

    (Hanyang University)

  • Steve Park

    (Korea Advanced Institute of Science and Technology (KAIST)
    KAIST Institute for Health Science and Technology)

  • Unyong Jeong

    (Pohang University of Science and Technology (POSTECH))

  • Do Hwan Kim

    (Hanyang University
    Hanyang University
    Hanyang University)

  • Sung-Min Park

    (Pohang University of Science and Technology (POSTECH)
    Pohang University of Science and Technology (POSTECH)
    Pohang University of Science and Technology (POSTECH)
    Yonsei University)

Abstract

Optimizing stimulation protocols for peripheral neuromodulation often depends on patient feedback, which can result in inconsistent clinical outcomes. Here we present a closed-loop control system for peripheral nerve stimulation (PNS) that utilizes evoked compound action potential (ECAP) feedback to regulate stimulation parameters, addressing the limitations of traditional methods. Unlike established closed-loop control techniques in the central nervous system, such as local field potential and spike analysis, a comparable approach for the peripheral nervous system remains underdeveloped. ECAPs can be consistently observed across peripheral nerves, providing a reliable measure of nerve activation. We developed a fully implantable device and neural interface for tibial nerve stimulation (TNS) that incorporates the proposed closed-loop system. This TNS system shows promise as a PNS treatment for alleviating overactive bladder symptoms. In a rat model, the system demonstrated longer micturition intervals and greater effectiveness compared to conventional motor response-based control.

Suggested Citation

  • Young-Soo Lim & Ji Hong Kim & Junho Kim & MinhDuc Hoang & Wonok Kang & Mattew Koh & Won Hyuk Choi & Steve Park & Unyong Jeong & Do Hwan Kim & Sung-Min Park, 2025. "Precise control of tibial nerve stimulation for bladder regulation via evoked compound action potential feedback mechanisms," Nature Communications, Nature, vol. 16(1), pages 1-12, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-59436-4
    DOI: 10.1038/s41467-025-59436-4
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    References listed on IDEAS

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    1. Aaron D. Mickle & Sang Min Won & Kyung Nim Noh & Jangyeol Yoon & Kathleen W. Meacham & Yeguang Xue & Lisa A. McIlvried & Bryan A. Copits & Vijay K. Samineni & Kaitlyn E. Crawford & Do Hoon Kim & Paulo, 2019. "A wireless closed-loop system for optogenetic peripheral neuromodulation," Nature, Nature, vol. 565(7739), pages 361-365, January.
    2. Wonok Kang & Chanyang Ju & Jaesoon Joo & Jiho Lee & Young-Min Shon & Sung-Min Park, 2022. "Closed-loop direct control of seizure focus in a rodent model of temporal lobe epilepsy via localized electric fields applied sequentially," Nature Communications, Nature, vol. 13(1), pages 1-18, December.
    3. Enrico Ravagli & Svetlana Mastitskaya & Nicole Thompson & Francesco Iacoviello & Paul R. Shearing & Justin Perkins & Alexander V. Gourine & Kirill Aristovich & David Holder, 2020. "Imaging fascicular organization of rat sciatic nerves with fast neural electrical impedance tomography," Nature Communications, Nature, vol. 11(1), pages 1-10, December.
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