Intravesical Electrical Stimulation Improves Abnormal Prefrontal Brain Activity in Patients With Underactive Bladder: A Possible Central Mechanism
Purpose The aim of this study was to explore the mechanisms of central brain action in patients with neurogenic underactive bladder (UAB) treated with intravesical electrical stimulation (IVES). Methods We prospectively recruited patients with neurogenic UAB who chose to receive IVES treatment and h...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Continence Society
2023-12-01
|
| Series: | International Neurourology Journal |
| Subjects: | |
| Online Access: | http://einj.org/upload/pdf/inj-2346232-116.pdf |
| _version_ | 1797367639038754816 |
|---|---|
| author | Han Deng Limin Liao Juan Wu Li Wan |
| author_facet | Han Deng Limin Liao Juan Wu Li Wan |
| author_sort | Han Deng |
| collection | DOAJ |
| description | Purpose The aim of this study was to explore the mechanisms of central brain action in patients with neurogenic underactive bladder (UAB) treated with intravesical electrical stimulation (IVES). Methods We prospectively recruited patients with neurogenic UAB who chose to receive IVES treatment and healthy subjects (HS). At baseline, the following data were obtained: a 72-hour voiding diary; measurements of postvoid residual urine (PVR), voiding efficiency (VE) and first sensation of bladder filling (FS); American Urological Association Symptom Index Quality of Life (AUA-SI-QOL) scores, and functional near-infrared spectroscopy scans of the prefrontal cortex in the voiding stage. All UAB patients were re-evaluated for these indices after completing 4 weeks of IVES. A >50% improvement in PVR was defined as successful IVES treatment. Prefrontal activity was analyzed using the NIRS_KIT software, corrected with the false discovery rate (P<0.05). Statistical analysis was performed using IBM SPSS Statistics ver. 22.0, and P<0.05 was considered statistically significant. Results Eighteen UAB patients and 16 HS were included. IVES treatment was successful in 11 UAB patients and failed in 7. The PVR, VE, 24-hour clean intermittent catheterization, FS volume, and AUA-SI-QOL scores of the UAB group significantly improved after successful IVES treatment. BA9 (right dorsolateral prefrontal cortex [DLPFC]) and BA10 (right frontal pole) were significantly activated after successful IVES, and no significant difference was found between the successful group and HS group after IVES. Before IVES, BA10 (right frontal pole) was significantly deactivated in the failed group compared with the successful group. Conclusions The possible central mechanism of IVES treatment for neurogenic UAB is that IVES reactivates the right DLPFC and right frontal pole. |
| first_indexed | 2024-03-08T17:21:11Z |
| format | Article |
| id | doaj.art-d067f7daa2504841a1d23be50a9c1608 |
| institution | Directory Open Access Journal |
| issn | 2093-4777 2093-6931 |
| language | English |
| last_indexed | 2024-03-08T17:21:11Z |
| publishDate | 2023-12-01 |
| publisher | Korean Continence Society |
| record_format | Article |
| series | International Neurourology Journal |
| spelling | doaj.art-d067f7daa2504841a1d23be50a9c16082024-01-03T04:47:58ZengKorean Continence SocietyInternational Neurourology Journal2093-47772093-69312023-12-0127426027010.5213/inj.2346232.1161086Intravesical Electrical Stimulation Improves Abnormal Prefrontal Brain Activity in Patients With Underactive Bladder: A Possible Central MechanismHan Deng0Limin Liao1Juan Wu2Li Wan3 Department of Urology, China Rehabilitation Research Centre, Rehabilitation School of Capital Medical University, Beijing, China Department of Urology, China Rehabilitation Research Centre, Rehabilitation School of Capital Medical University, Beijing, China Department of Urology, China Rehabilitation Research Centre, Rehabilitation School of Capital Medical University, Beijing, China Department of Urology, China Rehabilitation Research Centre, Rehabilitation School of Capital Medical University, Beijing, ChinaPurpose The aim of this study was to explore the mechanisms of central brain action in patients with neurogenic underactive bladder (UAB) treated with intravesical electrical stimulation (IVES). Methods We prospectively recruited patients with neurogenic UAB who chose to receive IVES treatment and healthy subjects (HS). At baseline, the following data were obtained: a 72-hour voiding diary; measurements of postvoid residual urine (PVR), voiding efficiency (VE) and first sensation of bladder filling (FS); American Urological Association Symptom Index Quality of Life (AUA-SI-QOL) scores, and functional near-infrared spectroscopy scans of the prefrontal cortex in the voiding stage. All UAB patients were re-evaluated for these indices after completing 4 weeks of IVES. A >50% improvement in PVR was defined as successful IVES treatment. Prefrontal activity was analyzed using the NIRS_KIT software, corrected with the false discovery rate (P<0.05). Statistical analysis was performed using IBM SPSS Statistics ver. 22.0, and P<0.05 was considered statistically significant. Results Eighteen UAB patients and 16 HS were included. IVES treatment was successful in 11 UAB patients and failed in 7. The PVR, VE, 24-hour clean intermittent catheterization, FS volume, and AUA-SI-QOL scores of the UAB group significantly improved after successful IVES treatment. BA9 (right dorsolateral prefrontal cortex [DLPFC]) and BA10 (right frontal pole) were significantly activated after successful IVES, and no significant difference was found between the successful group and HS group after IVES. Before IVES, BA10 (right frontal pole) was significantly deactivated in the failed group compared with the successful group. Conclusions The possible central mechanism of IVES treatment for neurogenic UAB is that IVES reactivates the right DLPFC and right frontal pole.http://einj.org/upload/pdf/inj-2346232-116.pdfneurogenicintravesical electrical stimulationunderactive bladderpostvoid residual urinefunctional near-infrared spectroscopy |
| spellingShingle | Han Deng Limin Liao Juan Wu Li Wan Intravesical Electrical Stimulation Improves Abnormal Prefrontal Brain Activity in Patients With Underactive Bladder: A Possible Central Mechanism International Neurourology Journal neurogenic intravesical electrical stimulation underactive bladder postvoid residual urine functional near-infrared spectroscopy |
| title | Intravesical Electrical Stimulation Improves Abnormal Prefrontal Brain Activity in Patients With Underactive Bladder: A Possible Central Mechanism |
| title_full | Intravesical Electrical Stimulation Improves Abnormal Prefrontal Brain Activity in Patients With Underactive Bladder: A Possible Central Mechanism |
| title_fullStr | Intravesical Electrical Stimulation Improves Abnormal Prefrontal Brain Activity in Patients With Underactive Bladder: A Possible Central Mechanism |
| title_full_unstemmed | Intravesical Electrical Stimulation Improves Abnormal Prefrontal Brain Activity in Patients With Underactive Bladder: A Possible Central Mechanism |
| title_short | Intravesical Electrical Stimulation Improves Abnormal Prefrontal Brain Activity in Patients With Underactive Bladder: A Possible Central Mechanism |
| title_sort | intravesical electrical stimulation improves abnormal prefrontal brain activity in patients with underactive bladder a possible central mechanism |
| topic | neurogenic intravesical electrical stimulation underactive bladder postvoid residual urine functional near-infrared spectroscopy |
| url | http://einj.org/upload/pdf/inj-2346232-116.pdf |
| work_keys_str_mv | AT handeng intravesicalelectricalstimulationimprovesabnormalprefrontalbrainactivityinpatientswithunderactivebladderapossiblecentralmechanism AT liminliao intravesicalelectricalstimulationimprovesabnormalprefrontalbrainactivityinpatientswithunderactivebladderapossiblecentralmechanism AT juanwu intravesicalelectricalstimulationimprovesabnormalprefrontalbrainactivityinpatientswithunderactivebladderapossiblecentralmechanism AT liwan intravesicalelectricalstimulationimprovesabnormalprefrontalbrainactivityinpatientswithunderactivebladderapossiblecentralmechanism |