Khasanah Nurida, Chin Hung-Yen, Lo Wei-Lun, Lin Bor-Shing, Chen Hung-Chou, Liou Jian-Chiun, Wu Chun-Wei, Peng Chih-Wei
Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan; Department of Obstetrics and Gynecology, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada-Dr Sardjito General Hospital, Yogyakarta, Indonesia.
Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Biomed J. 2025 Jun;48(3):100775. doi: 10.1016/j.bj.2024.100775. Epub 2024 Jul 25.
The current treatment options for overactive bladder (OAB) continue to pose challenges for refractory cases and may involve invasive procedures. To assess the potential benefit of non-invasive repetitive peripheral magnetic stimulation (rPMS) on sacral roots using intermittent theta burst stimulation (iTBS) as a treatment option for OAB. The study involved a total of 33 rats, which were divided into three different experimental phases.
To induce bladder overactivity rats were pretreated with a continuous transvesical infusion of 0.5% acetic acid (AA). During bladder infusion, the intravesical pressure was recorded using cystometrography (CMG) to investigate the effects of AA pretreatment and the therapeutic intervention of acute sacral rPMS using iTBS.
Pre-application of rPMS with iTBS at a 100% intensity significantly extended the mean first voiding time (Tv) in normal healthy rats to 132%. Acute rPMS iTBS at a 100% intensity resulted in a significant increase of the inter-contraction interval (ICI) to 121%. An AA model was established with continuous saline infusion after 0.5% AA treatment and resulted in significant reductions of Tv to 42% and ICI to 56% of the corresponding control values. Subsequently, rPMS iTBS at a 100% intensity on the sacral nerve effectively inhibited AA-induced bladder overactivity and significantly increased the ICI to 167%-222%. No significant changes in maximum bladder pressure (Pmax) were found.
Sacral nerve rPMS with iTBS demonstrated the ability to suppress AA-induced bladder overactivity. This promising modality could be developed as an alternative approach to enhance bladder continence in OAB syndrome patients.
目前膀胱过度活动症（OAB）的治疗方案对于难治性病例仍然构成挑战，且可能涉及侵入性手术。为了评估使用间歇性θ波爆发刺激（iTBS）进行非侵入性重复外周磁刺激（rPMS）作用于骶神经根对OAB的潜在益处。该研究共涉及33只大鼠，分为三个不同的实验阶段。
为诱导膀胱过度活动，对大鼠进行连续经膀胱输注0.5%乙酸（AA）预处理。在膀胱输注期间，使用膀胱压力描记法（CMG）记录膀胱内压，以研究AA预处理的效果以及使用iTBS对骶部rPMS进行急性治疗干预的效果。
以100%强度的iTBS预先应用rPMS可使正常健康大鼠的平均首次排尿时间（Tv）显著延长至132%。以100%强度进行急性rPMS iTBS可使收缩间期（ICI）显著增加至121%。在0.5% AA处理后通过连续输注生理盐水建立AA模型，导致Tv显著降低至相应对照值的42%，ICI降低至56%。随后，以100%强度对骶神经进行rPMS iTBS可有效抑制AA诱导的膀胱过度活动，并使ICI显著增加至167%-222%。未发现最大膀胱压力（Pmax）有显著变化。
骶神经rPMS联合iTBS显示出抑制AA诱导的膀胱过度活动的能力。这种有前景的方法可开发成为增强OAB综合征患者膀胱控尿能力的替代方法。
