Kreydin Evgeniy, Zhong Hui, Latack Kyle, Ye Shirley, Edgerton V Reggie, Gad Parag
Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
Rancho Research Institute, Rancho Los Amigos National Rehabilitation Center, Downey, CA, United States.
Front Syst Neurosci. 2020 Feb 6;14:1. doi: 10.3389/fnsys.2020.00001. eCollection 2020.
Neuromodulation is a therapeutic technique that is well-established in the treatment of idiopathic Lower urinary tract (LUT) dysfunction such as overactive bladder (OAB). We have recently developed a novel neuromodulation approach, Transcutaneous Electrical Spinal Cord Neuromodulation (TESCoN) and demonstrated its acute effects on LUT dysfunction after spinal cord injury (SCI) during urodynamic studies. We found that TESCoN can promote urinary storage and induce urinary voiding when delivered during urodynamic studies. The objective of this study was to determine whether TESCoN can retrain the spinal neural networks to induce chronic improvement in the LUT, such that positive changes can persist even in the absence of stimulation. In addition, we wished to examine the effect of TESCoN on LUT dysfunction due to multiple pathologies. To achieve this objective, 14 patients [SCI = 5, stroke = 5, multiple sclerosis (MS) = 3, and idiopathic OAB (iOAB) = 1] completed 24 sessions of TESCoN over the course of 8 weeks. Patients completed urodynamic studies before and after undergoing TESCoN therapy. Additionally, each subject completed a voiding diary and the Neurogenic Bladder Symptom Score questionnaire before and after receiving TESCoN therapy. We found that TESCoN led to decreased detrusor overactivity, improved continence, and enhanced LUT sensation across the different pathologies underlying LUT dysfunction. This study serves as a pilot in preparation for a rigorous randomized placebo-controlled trial designed to demonstrate the effect of TESCoN on LUT function in neurogenic and non-neurogenic conditions.
Non-Surgical modality to reduce incidence of urinary incontinence and improve neurogenic bladder symptom scores (NBSS) in individuals with neurogenic bladder due to spinal cord injury or stroke.
神经调节是一种在治疗特发性下尿路（LUT）功能障碍（如膀胱过度活动症（OAB））方面已得到充分确立的治疗技术。我们最近开发了一种新型神经调节方法，即经皮脊髓电刺激神经调节（TESCoN），并在尿动力学研究中证明了其对脊髓损伤（SCI）后LUT功能障碍的急性影响。我们发现，在尿动力学研究期间进行TESCoN刺激时，它可以促进尿液储存并诱导排尿。本研究的目的是确定TESCoN是否能够重新训练脊髓神经网络，从而在LUT中诱导出慢性改善，使积极变化即使在没有刺激的情况下也能持续存在。此外，我们希望研究TESCoN对多种病因导致的LUT功能障碍的影响。为实现这一目标，14名患者[SCI = 5例，中风 = 5例，多发性硬化症（MS） = 3例，特发性OAB（iOAB） = 1例]在8周内完成了24次TESCoN治疗。患者在接受TESCoN治疗前后均完成了尿动力学研究。此外，每个受试者在接受TESCoN治疗前后均完成了排尿日记和神经源性膀胱症状评分问卷。我们发现，TESCoN可减少不同病因导致的LUT功能障碍患者的逼尿肌过度活动，改善控尿能力，并增强LUT感觉。本研究作为一项先导研究，为一项严格的随机安慰剂对照试验做准备，该试验旨在证明TESCoN对神经源性和非神经源性疾病中LUT功能的影响。
一种非手术方式，可降低脊髓损伤或中风所致神经源性膀胱患者的尿失禁发生率，并改善神经源性膀胱症状评分（NBSS）。
