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[经颅刺激在盆腔和会阴疾病中的应用价值]

[Interest of transcranial stimulation in pelvic and perineal disorders].

作者信息

Vacher P, Charlanes A, Chesnel C, Pagès A, Malot C, Le Breton F, Amarenco G, Manceau P

机构信息

GREEN GRC-01 UPMC (group of clinical research in neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France.

GREEN GRC-01 UPMC (group of clinical research in neuro-urology), Sorbonne university, 75005 Paris, France; Department of neuro-urology, Tenon hospital, AP-HP, 4, rue de la Chine, 75020 Paris, France.

出版信息

Prog Urol. 2019 Jul;29(7):349-359. doi: 10.1016/j.purol.2019.03.001. Epub 2019 Apr 26.

Abstract

OBJECTIVE

The aim of this article was to describe the diagnostic and therapeutic value of transcranial stimulation in pelvic and perineal disorders.

METHODS

A literature review (Medline database and Google scholar) with no time limit was performed using keywords: "transcranial direct stimulation", "transcranial magnetic stimulation", "neurogenic bladder", "urinary incontinence", "Parkinson disease", "multiple sclerosis", "stroke", "muscle spasticity", "pelvic pain", "visceral pain".

RESULTS

Twelve articles have been selected. Transcranial magnetic or electrical stimulation is a noninvasive neuromodulation technique widely used to establish brain maps to highlight causal relationships between brain and function. Regarding pelvic-perineal disorders, repeated transcranial stimulation has shown significant effects for the treatment of overactive bladder in Parkinson's disease (P<0.05) and multiple sclerosis, but also for the treatment of refractory chronic pelvic pain (P=0.026). Finally, therapeutic effects have also been demonstrated in irritable bowel syndrome. No evidence of efficacy was found on genito-sexual disorders.

CONCLUSION

Data from the literature suggest that transcranial stimulation is a noninvasive treatment that may have a role in the management of pelvic and perineal disorders. Its promising field of action would require prospective and randomized studies on a larger scale.

摘要

目的

本文旨在描述经颅刺激在盆腔和会阴疾病中的诊断和治疗价值。

方法

使用关键词“经颅直接刺激”“经颅磁刺激”“神经源性膀胱”“尿失禁”“帕金森病”“多发性硬化症”“中风”“肌肉痉挛”“盆腔疼痛”“内脏疼痛”,对无时间限制的文献(Medline数据库和谷歌学术)进行综述。

结果

共筛选出12篇文章。经颅磁刺激或电刺激是一种非侵入性神经调节技术,广泛用于建立脑图谱,以突出大脑与功能之间的因果关系。对于盆腔 - 会阴疾病,重复经颅刺激已显示出对帕金森病(P<0.05)和多发性硬化症中膀胱过度活动症的治疗有显著效果,对难治性慢性盆腔疼痛的治疗也有效果(P = 0.026)。最后,在肠易激综合征中也证实了治疗效果。在生殖 - 性障碍方面未发现有效证据。

结论

文献数据表明,经颅刺激是一种非侵入性治疗方法,可能在盆腔和会阴疾病的管理中发挥作用。其有前景的作用领域需要进行更大规模的前瞻性随机研究。

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