Ohannessian A, Kaboré F A, Agostini A, Lenne Aurier K, Witjas T, Azulay J-P, Karsenty G
Service de gynécologie-obstétrique, Aix-Marseille université, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France.
Prog Urol. 2013 Sep;23(11):936-9. doi: 10.1016/j.purol.2013.07.004. Epub 2013 Aug 6.
To evaluate the efficacy of chronic transcutaneous tibial nerve stimulation (TNS) on overactive bladder syndrome in female patients with Parkinson's disease (PD) and multiple system atrophy (MSA).
A prospective monocentric study enrolled six female patients with PD or MSA suffering from overactive bladder syndrome for a six-week study period. Daily sessions of 20 minutes of TNS were provided. The primary outcome measurement was the Patient Global Impression of Improvement (PGI-I scale). The secondary outcomes measurements were symptom and quality of life scores, bladder diary and urodynamics. The outcomes after 6 weeks of TNS were compared to baseline.
TNS was considered as an effective treatment by five patients out of six (83%) who ask to pursue the treatment and were still doing it 6 months after the end of the study. A trend improvement was observed in only two of the secondary evaluation criteria the V8 median score 21/40 to 14/40 (P=0.2) and the maximum cystometric capacity increased from 211 mL ± 106 to 260 mL ± 226 (P=0.6) after SNT.
Although urodynamics and symptoms scores did not show significant difference, an efficacy of TNS on overactive bladder in PD and MSA is possible. Additional placebo controlled works enrolling more patients are required to ensure these preliminary results.
评估慢性经皮胫神经刺激（TNS）对帕金森病（PD）和多系统萎缩（MSA）女性患者膀胱过度活动症的疗效。
一项前瞻性单中心研究纳入了6名患有膀胱过度活动症的PD或MSA女性患者，研究为期6周。每天进行20分钟的TNS治疗。主要结局指标是患者总体改善印象（PGI-I量表）。次要结局指标是症状和生活质量评分、膀胱日记和尿动力学检查。将TNS治疗6周后的结局与基线进行比较。
6名患者中有5名（83%）认为TNS是一种有效的治疗方法，她们要求继续治疗，并且在研究结束6个月后仍在进行治疗。在仅有的两项次要评估标准中观察到有改善趋势，V8中位数评分从21/40降至14/40（P = 0.2），SNT后最大膀胱测压容量从211 mL±106增加至260 mL±226（P = 0.6）。
虽然尿动力学和症状评分没有显示出显著差异，但TNS对PD和MSA患者的膀胱过度活动症可能有效。需要开展更多纳入更多患者的安慰剂对照研究来证实这些初步结果。
