Dr. Hubscher’s research involves a multidisciplinary approach geared toward understanding the circuitries and neural mechanisms underlying urinary, bowel and sexual functions.  Our research since the mid-1990’s has focused on the impact of spinal cord injury on pelvic organ functions with the goal of developing more effective therapeutic approaches for translation directly to the clinic. Translational studies since 2014, through collaborations at The University of Louisville’s Kentucky Spinal Cord Injury Research Center at Frazier Rehab Institute, have involved pre-clinical and clinical experiments being done in parallel. Various combinations of neurophysiological, behavioral, immunohistochemical, molecular and neuroanatomical techniques are being used in Dr. Hubscher’s pre-clinical laboratory. Clinical assessments include urodynamics, anorectal manometry, ultrasound of the upper and lower urinary tract, and various internationally standardized questionnaires. We work collaboratively across multiple disciplines that include experts in urology, gastroenterology, neurosurgery, physical medicine & rehabilitatiion, and bioengineering to employ a research driven “Discovery-to-Recovery” approach.

Current Projects

1) Effects of activity dependent plasticity on recovery of bladder and sexual function after spinal cord injury (National Institutes of Health): The goals in the current phase of this ongoing multi-disciplinary study incorporating critical cross viscero-visceral intersystem interactions are a) to investigate in a controlled laboratory setting and then with mobile at-home monitoring the extent, severity and frequency of occurrence of autonomic dysreflexia 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 b) to regulate cardiovascular function therapeutically as part of bladder and bowel management using spinal cord epidural stimulation in order to normalize blood pressure.

2) Functional mapping with lumbosacral epidural stimulation for restoration of bladder function after spinal cord injury (National Institutes of Health): The goals of this spinal cord epidural stimulation (scES) project are a) to determine the optimal stimulation parameters for bladder storage and emptying in SCI research participants already implanted with the scES Medtronic device (16 electrode array from L1-S1); b) to quantify the long-term effects of daily bladder training using optimal scES parameters; c) to assess secondary benefits (bladder medication usage, susceptibility to urinary tract infections, indirect cardiovascular, bowel and sexual function benefits) of long-term bladder training; d) to enable dynamic human in-the-loop sensor feedback learning algorithm-controlled neuromodulation of micturition pathways and cardiovascular function in the home environment and improve the transition from bladder storage to voiding in the home-setting by flexibly adjusting the preset parameters; and e) to address with a small animal model the impact of scES location and stimulation parameters on bladder and bowel function in intact, T9-transected and T9-contused male and female rats.

3) Effects of activity dependent plasticity on bowel function after spinal cord injury (Department of Defense): The goal of the current ongoing experiments is to a) collect baseline outcome data on colonic motility and rectal/anal sphincter dynamics at multiple time-points after incomplete SCI and b) examine the impact of activity based training on bowel function with various time manipulations to address a key question regarding the maintenance of benefits from the locomotor training rehabilitation strategy.

4) Spinal Cord Injury Induced Polyuria (Craig H. Neilsen Foundation): The overall objective of the current ongoing pre-clinical study on polyuria, the overproduction of urine (which from a clinical standpoint leads to more frequent bladder catheterizations and disruptions in sleep and daily activities), is to a) assess the development and maintenance of SCI induced polyuria and the mechanisms that underlies it and b) strategies, through activity-based therapy and/or pharmacologic interventions, that may be taken to improve associated deficits. By understanding and treating SCI induced polyuria, the number of daily catheterizations may be decreased as well as the frequency of recurrent urinary tract infections, which would together lower medical costs and improve quality of life in SCI individuals.

Key Recent Publications

Hoey RF, Medina-Aguiñaga D, Khalifa F, Ugiliweneza B,Zdunowski S, Fell J, Naglah A, El-Baz AS, Herrity AN, Harkema SJ, Hubscher CH. Bladder and bowel responses to lumbosacral epidural stimulation in uninjured and transected anesthetized rats. Sci Rep 2021, Feb 8;11(1):3268. 

Herrity AN, Aslan S, Ugiliweneza B, Mohamed A, Hubscher CH, Harkema SJ. Improvements in bladder function following activity-based recovery training with epidural stimulation after chronic spinal cord injury. Front. Syst. Neurosci 2021, 14:614691. 

Medina-Aguiñaga D, Hoey RF, Munoz A, Altamira-Camacho M, Quintanar JL, Hubscher CH. Choice of cystometric technique impacts detrusor contractile dynamics in Wistar rats. Physiol Rep 2021, Jan;9(2):e14724. 

Steadman CJ, Vangoor SS, Hubscher CH. Kinematic analysis of penile reflexes in a rat model of spinal cord injury. Asian J Androl 2021, Jan-Feb;23(1):30-35.

Hubscher CH, Herrity AN, Wyles J, Gallahar A, Johnson K, Willhite AM, Harkema SJ. Impact of different forms of activity-based training on bladder, bowel and sexual function following spinal cord injury. Arch Phys Med Rehabil 2020, Dec 2; S0003-9993(20)31260-0. 

Hoey RF, Hubscher CH. Investigation of Bowel Function with Anorectal Manometry in a Rat Spinal Cord Contusion Model. J Neurotrauma 2020, Sept 15;37:1871-982.

Gumbel JH, Montgomery LR, Yang C, Hubscher CH. Activity-based training reverses SCI-induced changes in kidney receptor densities and membrane proteins. J Neurotrauma 2020, Feb 1;37(3): 555-563.

Steadman CJ, Vangoor SS, Hubscher CH. Telemetric monitoring of penile pressure during mating in rats after chronic spinal cord injury. AJP-Reg Int Comp Physiol 2019, Nov 1;317(5): R673-R683.

Steadman CJ, Hoey RF, Montgomery LR, Hubscher CH. Locomotor training alters penile reflex responses in a rat model of spinal cord injury. J Sex Med 2019, Aug;16(8):1143-1154.

Gumbel JH, Steadman CJ, Hoey RF, Armstrong JE, Fell JD, Yang CB, Montgomery LR, Hubscher CH. Activity-based training on a treadmill with spinal cord injured Wistar rats. J Vis Exp 2019, Jan 16(143).

Herrity AN, Williams CS, Angeli CA, Harkema SJ, Hubscher CH. Lumbosacral spinal cord epidural stimulation improves voiding function after human spinal cord injury. Scientific Reports 2018, Jun 6;8(1): 8688.

Hubscher CH, Herrity AN, Williams CS, Montgomery LR, Willhite AM, Angeli CA, Harkema SJ. Improvements in bladder, bowel and sexual outcomes following task-specific locomotor training in human spinal cord injury. PLOS One 2018, Jan 31;13(1): e0190998.

Montgomery LR, Hubscher CH. Altered vasopressin and natriuretic peptide levels in a rat model of spinal cord injury - Implications for the development of polyuria. Am J Physiol Renal Physiol 2018, 314: F58-F66.