Motor and sensory responses after percutaneous tibial nerve stimulation in multiple sclerosis patients with lower urinary tract symptoms treated in daily practice

Zecca, Chiara; Digesu, G. Alessandro; Robshaw, P.; Puccini, Federica; Khullar, Vik; Tubaro, Andrea; Gobbi, Claudio

doi:10.1111/ene.12339

Cited by 20 publications

(15 citation statements)

References 24 publications

(56 reference statements)

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“…This supports previous observations of the benefits of TNS in patients with neurological disease. Several studies have already demonstrated the efficacy of PTNS in different patient groups with neurological disease ( 15 - 20 ). de Seze et al performed a multicentric study of 70 patients with MS reporting symptoms of OAB using a TENS machine which was applied for 20 minutes daily and noted by day 30 significant improvements in urgency and frequency ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

Feasibility of using a novel non-invasive ambulatory tibial nerve stimulation device for the home-based treatment of overactive bladder symptoms

Seth

Gonzales

Haslam

et al. 2018

Transl. Androl. Urol

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BackgroundTo evaluate safety, acceptability and pilot efficacy of transcutaneous low-frequency tibial nerve stimulation (TNS) using a novel device as home-based neuromodulation.MethodsIn this single-centre pilot study, 48 patients with overactive bladder (OAB) (24 with neurogenic and 24 with idiopathic OAB) were randomized to use a self-applicating ambulatory skin-adhering device stimulating transcutaneously the tibial nerve at 1 Hz for 30 minutes, either once daily or once weekly, for 12 weeks. Changes in OAB symptoms and QoL were measured at baseline, weeks 4, 8, and 12 using validated scoring instruments (ICIQ-OAB and ICIQ-LUTSqol), 3-day bladder diary and a Global Response Assessment (GRA) at week 12.ResultsThirty-four patients completed the study (idiopathic n=15, neurogenic n=19). No significant adverse effects were noted. Patients found the device acceptable. Eighteen patients (53%) reported a moderate or marked improvement in symptoms from the GRA. Between baseline and week-12, ICIQ-OAB part A sub-scores improved from mean (SD) 9.3 (2.5) to 7.5 (3.1), and from 9.1 (1.9) to 5.9 (1.7) in the daily and the weekly arms, respectively. ICIQ-LUTSqol part A sub-scores improved from mean (SD) 51 (12.8) to 44.2 (13.1) and 44.9 (9.0) to 35.9 (8.8) in the daily and the weekly arms, respectively. Bladder diary mean 24-hour frequency episodes improved from 11.5 to 8.8 at week 12 for both arms.ConclusionsThis novel ambulatory transcutaneous TNS (TTNS) device is safe and acceptable for use in patients reporting OAB symptoms as a form of home-based neuromodulation. A larger study however is required to confirm clinical efficacy.

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Section: Discussionmentioning

confidence: 99%

Feasibility of using a novel non-invasive ambulatory tibial nerve stimulation device for the home-based treatment of overactive bladder symptoms

Seth

Gonzales

Haslam

et al. 2018

Transl. Androl. Urol

View full text Add to dashboard Cite

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“…A few case series of patients with specific neurological diagnoses undergoing PTNS have been reported so far. These studies, predominantly in patients with MS, have demonstrated improvements in OAB symptoms following percutaneous and transcutaneous tibial nerve stimulation [26,7,17,14,27]. The mix of patients attending our clinic, therefore, provided a unique opportunity to assess differences between patients with and without neurological disease reporting OAB symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Kabay et al studied the benefits of PTNS in a small number of patients with multiple sclerosis (MS) and Parkinson's disease (PD) demonstrating improvements in urodynamic parameters such as maximum cystometric capacity and first involuntary detrusor contraction during bladder filling [10][11][12]. Another study demonstrated clinical benefit in patients with MS with OAB unresponsive to antimuscarinic medications [13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Outcomes following percutaneous tibial nerve stimulation (PTNS) treatment for neurogenic and idiopathic overactive bladder

et al. 2018

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“…Participants completed a validated autonomic symptom questionnaire (COMPASS‐31), which included general questions about bladder function; along with an additional optional bladder questionnaire. The bladder questionnaire was the King's Health Questionnaire, originally validated in women but used since in mixed populations . Data regarding storage symptoms (urinary frequency, nocturia, urinary urgency, and urge incontinence) were extracted from the questionnaire and summed to give a storage symptom score out of 16 (see supporting information for questionnaire details).…”

Section: Methodsmentioning

confidence: 99%

Investigation of urinary storage symptoms in Parkinson's disease utilizing structural MRI techniques

Roy

Griffiths

Aziz

et al. 2019

Neurourology and Urodynamics

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Background Lower urinary tract symptoms occur in 27% to 86% of patients with Parkinson's disease (PD), however, the mechanisms responsible for bladder dysfunction are not fully understood. This study utilized magnetic resonance imaging (MRI) to test the hypothesis that key brainstem bladder control areas (including the pontine micturition center and the pontine continence center (PCC) and their links with the basal ganglia are important in the development of urinary storage symptoms in PD. Methods Seventeen patients with PD completed a “bladder symptom questionnaire” and underwent diffusion‐weighted MRI (1.5 T). Storage symptom severity and MRI measures of white matter microstructural integrity were correlated using tract‐based spatial statistics. Results Mean diffusivity in the ventral brainstem correlated significantly with the bladder symptom severity in areas close to the predicted anatomical co‐ordinates of the PCC. Tracts seeded from these regions passed via areas involved in pelvic floor musculature control and urinary voiding including the cerebellum, pallidum, and precentral gyrus. Conclusion We used diffusion‐weighted MRI to investigate the role of the brainstem and its structural connections in the development of urinary storage symptoms in PD. Our data suggest that the brainstem degenerative change in the vicinity of the PCC may be implicated in the pathogenesis of storage symptoms in these patients.

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Motor and sensory responses after percutaneous tibial nerve stimulation in multiple sclerosis patients with lower urinary tract symptoms treated in daily practice

Abstract: A sensory response, either alone or in combination with a motor response, is more frequent and seems to be better associated with a successful outcome of PTNS than motor response alone.

Cited by 20 publications

References 24 publications

Feasibility of using a novel non-invasive ambulatory tibial nerve stimulation device for the home-based treatment of overactive bladder symptoms

Feasibility of using a novel non-invasive ambulatory tibial nerve stimulation device for the home-based treatment of overactive bladder symptoms

Outcomes following percutaneous tibial nerve stimulation (PTNS) treatment for neurogenic and idiopathic overactive bladder

Investigation of urinary storage symptoms in Parkinson's disease utilizing structural MRI techniques

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