<p>Clinical study of the effects of deep brain stimulation on urinary dysfunctions in patients with Parkinson’s disease</p>

Abstract

Purpose: To evaluate the effect of deep brain stimulation (DBS) on urinary dysfunctions in Parkinson’s patients. Patients and methods: A total of 416 patients, diagnosed with Parkinson’s disease (PD) based on the UK Parkinson’s Disease Society Brain Bank Diagnostic Criteria, were enrolled in the study, including 307 males and 109 females. The effects of DBS treatment on urinary functions during urination and bladder storage of these patients were evaluated using testing and assessment scales, such as the American Urological Association Symptom Index (AUA-SI), Overactive Bladder Symptom Scores (OAB-SS), Quality Of Life Scale (QOL), and urodynamic tests. The data were statistically analyzed with the chi-square test and both independent-samples t -test and paired-samples t -test were used in this study. Results: Symptoms of urinary dysfunctions, such as urinary frequency, urgency, and incontinence, in the patients with PD were notably relieved by DBS treatment ( P <0.05), and the OAB-SS and bladder storage problems were greatly improved as well ( P <0.05). Compared with those in male patients, DBS surgery significantly improved the AUA-SI, urinary symptom scores, and QOL in female PD patients ( P <0.05), as well as other functional indicators related to the urinary tract, including the maximum urinary flow rate, detrusor pressure at peak flow, and residual urine volume in female PD patients ( P <0.05). Conclusion: DBS surgery is effective in improving urinary functions in PD patients, as primarily reflected by the alleviation of urinary symptoms such as urinary frequency, urgency, and incontinence. Female PD patients displayed better urinary function outcomes from DBS treatment than did male patients.

The long-lasting post-stimulation inhibitory effects of bladder activity induced by posterior tibial nerve stimulation in unanesthetized rats

“…Typically, the persistent inhibitory effects of bladder activity with TNS are dependent on the central neural pathways. The neural circuit responsible for controlling micturition is located on the pontine micturition center [44][45][46] . Thus, the increased bladder capacity induced by 10 Hz TNS, as shown in Figs.…”

Does deep brain stimulation improve Parkinson’s disease-related lower urinary tract symptoms and voiding dysfunction?

“…A survey of PD patients comparing those who underwent DBS ( n = 220) with those who did not ( n = 196) showed significant improvements in frequency, urgency, incontinence, and overactive bladder symptom score in the DBS groups. Interestingly, these improvements were more substantial in female patients when compared to males [ 21 ]. In the EuroInf study, a multi-center, open label prospective study of 60 patients with PD, after a mean follow-up of 6 months, STN-DBS was associated with decreased urinary urgency, frequency, and nocturia [ 9 ].…”

Autonomic Dysfunction in Parkinson's Disease

“…Neuromodulation in the form of both percutaneous and transdermal tibial nerve stimulations has been used successfully in ameliorating overactive bladder symptoms, but experience specifically in individuals with PD currently is minimal [158]. Improvement in lower urinary tract symptoms in PD patients has been documented following deep brain stimulation surgery targeting the subthalamic nucleus [159,160]. In one study, improvement following DBS was more apparent in females than in males; the reason for this is unclear [160].…”

“…Improvement in lower urinary tract symptoms in PD patients has been documented following deep brain stimulation surgery targeting the subthalamic nucleus [159,160]. In one study, improvement following DBS was more apparent in females than in males; the reason for this is unclear [160].…”