MP52-12 PREDICTING RESPONSE TO TRANSCUTANEOUS ELECTRICAL SPINAL CORD NEUROMODULATION BASED ON PRE-TREATMENT MICTURITION-ASSOCIATED BRAIN ACTIVITY IN STROKE SURVIVORS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP52-12 PREDICTING RESPONSE TO TRANSCUTANEOUS ELECTRICAL SPINAL CORD NEUROMODULATION BASED ON PRE-TREATMENT MICTURITION-ASSOCIATED BRAIN ACTIVITY IN STROKE SURVIVORS Luis Alejandro Morales Ojeda, Veronica Stefania Montero Arcila, Rita Jen, Aidin Abedi, Priya Kohli, Sarah Ponce, David Chapman, Kay Jann, David Ginsberg, and Evgeniy Kreydin Luis Alejandro Morales OjedaLuis Alejandro Morales Ojeda More articles by this author , Veronica Stefania Montero ArcilaVeronica Stefania Montero Arcila More articles by this author , Rita JenRita Jen More articles by this author , Aidin AbediAidin Abedi More articles by this author , Priya KohliPriya Kohli More articles by this author , Sarah PonceSarah Ponce More articles by this author , David ChapmanDavid Chapman More articles by this author , Kay JannKay Jann More articles by this author , David GinsbergDavid Ginsberg More articles by this author , and Evgeniy KreydinEvgeniy Kreydin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003300.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Stroke patients often develop lower urinary tract symptoms (LUTS) due to disruption in the brain centers that control micturition. Transcutaneous spinal cord stimulation (TSCS) is a novel neuromodulation approach that has been previously shown to improve LUT function in these patients. However, the characteristics of responders to TSCS have not been previously identified. In this study, we assessed micturition-related brain activity as a biomarker of responsiveness to TSCS therapy for LUT dysfunction secondary to stroke. METHODS: Twelve patients with stroke-related LUTS were enrolled to receive 12 weeks (24 sessions) of TSCS in a prospective cohort study. Patients underwent simultaneous blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) and urodynamics during their baseline evaluation. LUTS were assessed using the International Consultation on Incontinence Overactive Bladder (ICIQ-OAB) questionnaire before and after completing TSCS. Responders were defined as those who reported ≥60% reduction in the ICIQ-OAB score. BOLD signal during maximal urgency (defined as 10 seconds preceding a detrusor contraction) was compared between responders and non-responders using statistical parametric mapping (p<0.01, cluster size >25 voxels). Models were controlled for age, sex, and time since stroke. RESULTS: Of 12 patients enrolled in the study, six were defined as responders to therapy, reporting a mean decrease in ICIQ-OAB by 8.6±0.91 points (p<0.01). Responders exhibited significantly higher BOLD signals in 16 clusters, including left insula, left middle cingulate cortex, bilateral cuneus, left precuneus, left precentral gyrus, left inferior frontal gyrus, and right temporal gyrus. Nonresponders exhibited significantly higher BOLD signals in 7 clusters centered in the corpus callosum and the basal ganglia. CONCLUSIONS: TSCS is a promising novel neuromodulation modality for the mitigation of neurogenic LUTS (NLUTS). Here we demonstrate that micturition-related brain activity may be a useful biomarker for predicting response to TSCS in patients with NLUTS secondary to stroke. Responders demonstrated higher BOLD signals in several cortical areas than non-responders, suggesting that a baseline level of brain activity may be necessary in order to have a successful outcome with TSCS. Source of Funding: Urology Care Foundation © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e707 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luis Alejandro Morales Ojeda More articles by this author Veronica Stefania Montero Arcila More articles by this author Rita Jen More articles by this author Aidin Abedi More articles by this author Priya Kohli More articles by this author Sarah Ponce More articles by this author David Chapman More articles by this author Kay Jann More articles by this author David Ginsberg More articles by this author Evgeniy Kreydin More articles by this author Expand All Advertisement PDF downloadLoading ...