Abstract
BackgroundAs a potential new treatment for overactive bladder (OAB), we investigated the feasibility of non-invasively activating multiple nerve targets in the lower leg.MethodsIn healthy participants, surface electrical stimulation (frequency = 20 Hz, pulse width = 200 μs) was used to target the tibial nerve, saphenous nerve, medial plantar nerve, and lateral plantar nerve. At each location, the stimulation amplitude was increased to define the thresholds for evoking (1) cutaneous sensation, (2) target nerve recruitment and (3) maximum tolerance.ResultsAll participants were able to tolerate stimulation amplitudes that were 2.1 ± 0.2 (range = 2.0 to 2.4) times the threshold for activating the target nerve.ConclusionsNon-invasive electrical stimulation can activate neural targets at levels that are consistent with evoking bladder-inhibitory reflex mechanisms. Further work is needed to test the clinical effects of stimulating one or more neural targets in OAB patients.
Highlights
As a potential new treatment for overactive bladder (OAB), we investigated the feasibility of noninvasively activating multiple nerve targets in the lower leg
We investigated the feasibility of using transcutaneous electrical nerve stimulation (TENS) to selectively activate multiple nerve targets located in the lower leg
Participants receiving SAFN stimulation indicated that the evoked sensation consistently radiated down to the medial malleolus (Fig. 3a)
Summary
As a potential new treatment for overactive bladder (OAB), we investigated the feasibility of noninvasively activating multiple nerve targets in the lower leg. Methods: In healthy participants, surface electrical stimulation (frequency = 20 Hz, pulse width = 200 μs) was used to target the tibial nerve, saphenous nerve, medial plantar nerve, and lateral plantar nerve. Patients may be provided with percutaneous tibial nerve stimulation (PTNS) therapy, which is a procedure performed in a clinical setting. It involves the insertion of a 34G stainless needle above the medial malleolus, through which electrical pulses are used to stimulate the tibial nerve. Clinical visits are repeated for 3 months, and if the patient responds to treatment, maintenance PTNS is provided every 3 weeks thereafter [8, 9]
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