Houston Methodist Hospital, Weill Cornell Medical College, Houston, Texas, USA.
Curr Opin Urol. 2024 Nov 1;34(6):412-421. doi: 10.1097/MOU.0000000000001223. Epub 2024 Sep 4.
The literature was reviewed for all noninvasive central nervous system (CNS) stimulation techniques, which includes transcranial brain or trans-spinal stimulation, in the aging population. Given the rising ubiquity of this technology, noninvasive nature, and low side-effect profile reported, this technology can have a big impact on the aging population. As patients afflicted with neurogenic disorders are living longer lives, a special emphasis is placed on the aging neurogenic population.
Noninvasive CNS stimulation techniques have been applied to major bladder and pelvic floor disorders such as voiding dysfunction, chronic pelvic pain, urgency and urge incontinence, lower urinary tract dysfunction, and situational urge incontinence in both the idiopathic and neurogenic populations. Overall, these noninvasive technologies demonstrate effectiveness for the treatment of these conditions with some studies showing effectiveness with longer-term follow-up suggesting lasting CNS remodeling.
Most manuscripts had a generally small number of patients and an even smaller number of geriatric patients represented. No studies were specifically designed to investigate geriatric outcomes. It is the hope of this systematic review to help model future studies according to existing literature, but with a focus on the geriatric population as they stand to gain the most from noninvasive technologies with limited adverse events.
目的综述:本文回顾了所有非侵入性的中枢神经系统(CNS)刺激技术,包括经颅脑刺激或经脊柱刺激,适用于老年人群。鉴于该技术的普及、非侵入性和报告的低副作用特性,这项技术可能会对老年人群产生重大影响。由于患有神经源性疾病的患者寿命更长,因此特别强调了老年神经源性人群。
最新发现:非侵入性 CNS 刺激技术已应用于主要的膀胱和盆底功能障碍,如排尿功能障碍、慢性盆腔疼痛、尿急和急迫性尿失禁、下尿路功能障碍以及特发性和神经源性人群中的情境性急迫性尿失禁。总的来说,这些非侵入性技术对于这些疾病的治疗有效,一些研究显示长期随访具有有效性,表明 CNS 重塑持久。
总结:大多数文献的患者数量普遍较少,老年患者的数量更少。没有专门设计的研究来调查老年患者的结果。希望本系统综述能够根据现有文献为未来的研究建模,但重点关注老年人群,因为他们从具有有限不良事件的非侵入性技术中获益最大。