Overactive bladder, lack of habituation, and central sensitisation: The sympathetic skin response as a possible diagnostic marker and neuromodulation as a treatment
Objectives: 1) to characterise clinically, neurophysiologically and manometrically the overactive bladder (OAB); 2) to objectify the lack of habituation in OAB; 3) to quantify the comorbidities associated with CS (central sensitisation); and 4) to evaluate the effect of neuromodulation (NM) of the t...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Neurology Perspectives |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667049623000042 |
| _version_ | 1811154713661407232 |
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| author | M.E. Fernández-Cuadros L.M. Martín-Martín M.J. Albaladejo-Florín O.S. Pérez-Moro S. Álava-Rabasa G. Goizueta-San-Martín |
| author_facet | M.E. Fernández-Cuadros L.M. Martín-Martín M.J. Albaladejo-Florín O.S. Pérez-Moro S. Álava-Rabasa G. Goizueta-San-Martín |
| author_sort | M.E. Fernández-Cuadros |
| collection | DOAJ |
| description | Objectives: 1) to characterise clinically, neurophysiologically and manometrically the overactive bladder (OAB); 2) to objectify the lack of habituation in OAB; 3) to quantify the comorbidities associated with CS (central sensitisation); and 4) to evaluate the effect of neuromodulation (NM) of the tibialis posterior nerve in OAB. Material and methods: Forty-seven patients, retrospective observational pre-post study.Intervention: manometric biofeedback and posterior tibial transcutaneous NM (PTNM), 8 sessions.Outcome variables: a) clinical (daytime urinary frequency [DUF] and nocturnal urinary frequency [NUF]), b) neurophysiological (latency, amplitude and percentage of habituation); c) comorbidities associated with CS; d) manometric (maximum and average pressure); at the beginning/end of treatment. Results: Age, 58.91 ± 13.27 years. Comorbidities associated with CS, 1.98 ± 0.32 (range 1–5 pathologies). Percentage of habituation, 88.6%. PTNM decreased DUF (10.4 ± 4.86 to 6.21 ± 1.87 episodes; P = .0001), and NUF (3.02 ± 1.66 to 1.17 ± 1 episodes; P = .0001). PTNM increased maximum (38.46 ± 23.06 to 42.61 ± 19.46 mmHg; P = .0964), and mean (7.63 ± 3.56 to 8.66 ± 4.76 mmHg; P = .1639) pressure. NMTP modified latency (1.32 ± 0.32 to 1.38 ± 0.32 s; P = .3397), and reduced amplitude (1.98 ± 1.28 to 1.67 ± 1.44 mV; P = .0004) and habituation (88.6 ± 23.5% at 70 ± 30.2%; P = .0001) of sympathetic skin response (SSR). Conclusion: The lack of habituation is a neurophysiological phenomenon present in OAB. PTNM improved clinical and neurophysiological variables. SSR is a neurophysiological test capable of objectifying lack of habituation and could characterize other response patterns (alteration of the ascending, central, descending or postganglionic pathway). Resumen: Objetivos: 1) caracterizar clínica, neurofisiológica y manométricamente la vejiga hiperactiva (VH); 2) objetivar la falta de habituación en VH; 3) cuantificar las comorbilidades asociadas a SC (sensibilización central); 4) evaluar el efecto de la neuromodulación (NM) del tibial posterior en VH. Material y Métodos: 47 pacientes, estudio observacional retrospectivo (antes-después).Intervención: biofeedback manométrico y NM transcutánea tibial posterior (NMTP), 8 sesiones.Variables resultado: a) clínicas (frecuencia urinaria diurna [FUD] y nocturna [FUN]), b) neurofisiológicas (latencia, amplitud y porcentaje de habituación de la respuesta simpático cutánea [RSC]); c) comorbilidades asociadas a SC; d) manométricas (fuerza máxima y media); al inicio-término del tratamiento. Resultados: Edad 58.91 ± 13.27 años. Comorbilidades asociadas a SC 1.98 ± 0.32 (rango 1–5 patologías). Porcentaje de habituación 88.6%. La NMTP disminuyó FUD (10.4 ± 4.86 a 6.21 ± 1.87 episodios; p = .0001), y FUN (3.02 ± 1.66 a 1.17 ± 1 episodios; p = .0001). La NMTP aumentó la Presión máxima (38.46 ± 23.06 a 42.61 ± 19.46 mmHg; p = .0964), y media (7.63 ± 3.56 a 8.66 ± 4.76 mmHg; p = .1639). La NMTP modificó la latencia (1.32 ± 0.32 a 1.38 ± 0.32 segundos; p = .3397), redujo la amplitud (1.98 ± 1.28 a 1.67 ± 1.44 mV; p = .0004), y la habituación (88.6 ± 23.5% a 70 ± 30.2%; p = .0001) de la RSC. Conclusión: La falta de habituación es un fenómeno neurofisiológico presente en VH. La NMTP mejoró las variables clínicas y neurofisiológicas. La RSC es una prueba neurofisiológica capaz de objetivar falta de habituación y podría caracterizar otros patrones de respuesta (alteración de la vía ascendente, central, descendente o postganglionar). |
| first_indexed | 2024-04-10T04:20:36Z |
| format | Article |
| id | doaj.art-5d12b33cf6284e92989ad094bbc3ebea |
| institution | Directory Open Access Journal |
| issn | 2667-0496 |
| language | English |
| last_indexed | 2024-04-10T04:20:36Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Neurology Perspectives |
| spelling | doaj.art-5d12b33cf6284e92989ad094bbc3ebea2023-03-11T04:20:50ZengElsevierNeurology Perspectives2667-04962023-01-0131100112Overactive bladder, lack of habituation, and central sensitisation: The sympathetic skin response as a possible diagnostic marker and neuromodulation as a treatmentM.E. Fernández-Cuadros0L.M. Martín-Martín1M.J. Albaladejo-Florín2O.S. Pérez-Moro3S. Álava-Rabasa4G. Goizueta-San-Martín5Servicio de Rehabilitación y Medicina Física, Hospital Universitario Santa Cristina, Madrid, Spain; Corresponding author.Servicio de Neurofisiología Clínica, Hospital Universitario Santa Cristina, Madrid, SpainServicio de Rehabilitación y Medicina Física, Hospital Universitario Santa Cristina, Madrid, SpainServicio de Rehabilitación y Medicina Física, Hospital Universitario Santa Cristina, Madrid, SpainServicio de Rehabilitación y Medicina Física, Hospital Universitario Santa Cristina, Madrid, SpainServicio de Neurofisiología Clínica, Hospital Universitario Santa Cristina, Madrid, SpainObjectives: 1) to characterise clinically, neurophysiologically and manometrically the overactive bladder (OAB); 2) to objectify the lack of habituation in OAB; 3) to quantify the comorbidities associated with CS (central sensitisation); and 4) to evaluate the effect of neuromodulation (NM) of the tibialis posterior nerve in OAB. Material and methods: Forty-seven patients, retrospective observational pre-post study.Intervention: manometric biofeedback and posterior tibial transcutaneous NM (PTNM), 8 sessions.Outcome variables: a) clinical (daytime urinary frequency [DUF] and nocturnal urinary frequency [NUF]), b) neurophysiological (latency, amplitude and percentage of habituation); c) comorbidities associated with CS; d) manometric (maximum and average pressure); at the beginning/end of treatment. Results: Age, 58.91 ± 13.27 years. Comorbidities associated with CS, 1.98 ± 0.32 (range 1–5 pathologies). Percentage of habituation, 88.6%. PTNM decreased DUF (10.4 ± 4.86 to 6.21 ± 1.87 episodes; P = .0001), and NUF (3.02 ± 1.66 to 1.17 ± 1 episodes; P = .0001). PTNM increased maximum (38.46 ± 23.06 to 42.61 ± 19.46 mmHg; P = .0964), and mean (7.63 ± 3.56 to 8.66 ± 4.76 mmHg; P = .1639) pressure. NMTP modified latency (1.32 ± 0.32 to 1.38 ± 0.32 s; P = .3397), and reduced amplitude (1.98 ± 1.28 to 1.67 ± 1.44 mV; P = .0004) and habituation (88.6 ± 23.5% at 70 ± 30.2%; P = .0001) of sympathetic skin response (SSR). Conclusion: The lack of habituation is a neurophysiological phenomenon present in OAB. PTNM improved clinical and neurophysiological variables. SSR is a neurophysiological test capable of objectifying lack of habituation and could characterize other response patterns (alteration of the ascending, central, descending or postganglionic pathway). Resumen: Objetivos: 1) caracterizar clínica, neurofisiológica y manométricamente la vejiga hiperactiva (VH); 2) objetivar la falta de habituación en VH; 3) cuantificar las comorbilidades asociadas a SC (sensibilización central); 4) evaluar el efecto de la neuromodulación (NM) del tibial posterior en VH. Material y Métodos: 47 pacientes, estudio observacional retrospectivo (antes-después).Intervención: biofeedback manométrico y NM transcutánea tibial posterior (NMTP), 8 sesiones.Variables resultado: a) clínicas (frecuencia urinaria diurna [FUD] y nocturna [FUN]), b) neurofisiológicas (latencia, amplitud y porcentaje de habituación de la respuesta simpático cutánea [RSC]); c) comorbilidades asociadas a SC; d) manométricas (fuerza máxima y media); al inicio-término del tratamiento. Resultados: Edad 58.91 ± 13.27 años. Comorbilidades asociadas a SC 1.98 ± 0.32 (rango 1–5 patologías). Porcentaje de habituación 88.6%. La NMTP disminuyó FUD (10.4 ± 4.86 a 6.21 ± 1.87 episodios; p = .0001), y FUN (3.02 ± 1.66 a 1.17 ± 1 episodios; p = .0001). La NMTP aumentó la Presión máxima (38.46 ± 23.06 a 42.61 ± 19.46 mmHg; p = .0964), y media (7.63 ± 3.56 a 8.66 ± 4.76 mmHg; p = .1639). La NMTP modificó la latencia (1.32 ± 0.32 a 1.38 ± 0.32 segundos; p = .3397), redujo la amplitud (1.98 ± 1.28 a 1.67 ± 1.44 mV; p = .0004), y la habituación (88.6 ± 23.5% a 70 ± 30.2%; p = .0001) de la RSC. Conclusión: La falta de habituación es un fenómeno neurofisiológico presente en VH. La NMTP mejoró las variables clínicas y neurofisiológicas. La RSC es una prueba neurofisiológica capaz de objetivar falta de habituación y podría caracterizar otros patrones de respuesta (alteración de la vía ascendente, central, descendente o postganglionar).http://www.sciencedirect.com/science/article/pii/S2667049623000042Vejiga hiperactivaFalta de habituaciónNeuromodulación del tibial posteriorSensibilización centralRespuesta simpático cutánea |
| spellingShingle | M.E. Fernández-Cuadros L.M. Martín-Martín M.J. Albaladejo-Florín O.S. Pérez-Moro S. Álava-Rabasa G. Goizueta-San-Martín Overactive bladder, lack of habituation, and central sensitisation: The sympathetic skin response as a possible diagnostic marker and neuromodulation as a treatment Neurology Perspectives Vejiga hiperactiva Falta de habituación Neuromodulación del tibial posterior Sensibilización central Respuesta simpático cutánea |
| title | Overactive bladder, lack of habituation, and central sensitisation: The sympathetic skin response as a possible diagnostic marker and neuromodulation as a treatment |
| title_full | Overactive bladder, lack of habituation, and central sensitisation: The sympathetic skin response as a possible diagnostic marker and neuromodulation as a treatment |
| title_fullStr | Overactive bladder, lack of habituation, and central sensitisation: The sympathetic skin response as a possible diagnostic marker and neuromodulation as a treatment |
| title_full_unstemmed | Overactive bladder, lack of habituation, and central sensitisation: The sympathetic skin response as a possible diagnostic marker and neuromodulation as a treatment |
| title_short | Overactive bladder, lack of habituation, and central sensitisation: The sympathetic skin response as a possible diagnostic marker and neuromodulation as a treatment |
| title_sort | overactive bladder lack of habituation and central sensitisation the sympathetic skin response as a possible diagnostic marker and neuromodulation as a treatment |
| topic | Vejiga hiperactiva Falta de habituación Neuromodulación del tibial posterior Sensibilización central Respuesta simpático cutánea |
| url | http://www.sciencedirect.com/science/article/pii/S2667049623000042 |
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