Liao K K, Chen J T, Lai K L, Liu C Y, Lin C Y, Lin Y Y, Yu B Kj, Wu Z A
Department of Neurology, Taipei Veterans General Hospital, 201, Section II, Shih-Pai Road, 11217 Taipei, Taiwan.
Neurophysiol Clin. 2008 Feb;38(1):39-43. doi: 10.1016/j.neucli.2007.09.004. Epub 2007 Oct 11.
It is presumed that idiopathic overactive bladder syndrome (OBS) is due to visceral hypersensitivity. Sacral-root stimulation can restore the bladder function, but its mechanism remains uncertain. It is well-known that long-term peripheral stimulation can induce brain plasticity. Hence, we investigated whether brain reorganization occurred along with clinical improvement after sacral-root stimulation.
Because toe flexion is the index for monitoring wire placement, we used the flexor hallucis brevis (FHB) as the target muscle. Transcranial magnetic stimulation (TMS) was applied to study motor cortex excitability and the brain mapping of the muscle.
Six patients with idiopathic OBS were included in the study. All demonstrated clinical improvement after sacral-root stimulation. Motor cortex excitability and the area of representation for the flexor hallucis brevis muscle increased for at least 30 min after sacral-root stimulation had terminated.
Our results showed that cerebral activities changed after sacral-root stimulation. The improvement in urinary urgency and urgency perception was probably due in part to brain reorganization.
推测特发性膀胱过度活动症（OBS）是由内脏超敏反应引起的。骶神经根刺激可恢复膀胱功能，但其机制仍不确定。众所周知，长期的外周刺激可诱导脑可塑性。因此，我们研究了骶神经根刺激后，随着临床症状改善，大脑是否发生了重组。
由于足趾屈曲是监测电极放置的指标，我们使用拇短屈肌（FHB）作为目标肌肉。应用经颅磁刺激（TMS）来研究运动皮层兴奋性和该肌肉的脑图谱。
6例特发性OBS患者纳入本研究。所有患者在骶神经根刺激后均表现出临床症状改善。骶神经根刺激结束后，运动皮层兴奋性和拇短屈肌代表区面积至少增加30分钟。
我们的结果表明，骶神经根刺激后大脑活动发生了变化。尿急和尿急感的改善可能部分归因于大脑重组。
