MP52-13 IMPROVED LOWER URINARY TRACT SYMPTOMS AND ASSOCIATED CHANGES IN MICTURITION-ASSOCIATED BRAIN ACTIVITY IN STROKE SURVIVORS FOLLOWING TRANSCUTANEOUS SPINAL CORD STIMULATION

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP52-13 IMPROVED LOWER URINARY TRACT SYMPTOMS AND ASSOCIATED CHANGES IN MICTURITION-ASSOCIATED BRAIN ACTIVITY IN STROKE SURVIVORS FOLLOWING TRANSCUTANEOUS SPINAL CORD STIMULATION David Chapman, Luis Alejandro Morales Ojeda, Veronica Stefania Montero Arcila, Sarah Ponce, Rita Jen, Nhi Ha, Parag Gad, Reggie Edgerton, David Ginsberg, Aidin Abedi, Kay Jann, and Evgeniy Kreydin David ChapmanDavid Chapman More articles by this author , Luis Alejandro Morales OjedaLuis Alejandro Morales Ojeda More articles by this author , Veronica Stefania Montero ArcilaVeronica Stefania Montero Arcila More articles by this author , Sarah PonceSarah Ponce More articles by this author , Rita JenRita Jen More articles by this author , Nhi HaNhi Ha More articles by this author , Parag GadParag Gad More articles by this author , Reggie EdgertonReggie Edgerton More articles by this author , David GinsbergDavid Ginsberg More articles by this author , Aidin AbediAidin Abedi More articles by this author , Kay JannKay Jann More articles by this author , and Evgeniy KreydinEvgeniy Kreydin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003300.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Stroke survivors often experience lower urinary tract dysfunction that can be difficult to treat and profoundly impacts their quality of life. After a stroke, micturition-associated brain activity (MABA) has been shown to rely on activation of primitive brain regions including the cerebellum and periaqueductal gray with less activation of cortical regions. Transcutaneous Spinal Cord Stimulation (TSCS), a novel technique of neuromodulation, is emerging as a powerful tool with growing clinical evidence in neuro-restoration potential. The objective was to evaluate changes in brain activity using functional MRI (fMRI) and patient reported outcome measures (PROM) following twelve weeks of TSCS. METHODS: Twelve patients with de novo lower urinary tract symptoms following a stroke prospectively underwent TSCS for 24 sessions. Blood oxygen level dependent (BOLD) brain activity changes detected with fMRI were collected during maximum urgency, measured 10 seconds prior to detrusor contraction. Patients completed a voiding diary, ICIQ-OAB questionnaire, and underwent fMRI+UDS before and after TSCS. Descriptive statistics and paired t-test were used when appropriate. RESULTS: Twelve patients (5 males, 7 females) with a mean age of 52.8±9.8 years old completed the study. After completion of TSCS, patients reported a decreased perception of urge per void (1.83±0.34 vs 0.92±0.21: p<0.05), number of urge incontinence episodes (6.96±2.12 vs 4.15±1.58: p><0.05), and an increased number of urge-free voids per 24 hours (0.27±0.09 vs 2.29±0.91; p<0.05). ICIQ-OAB scores were significantly lower post stimulation (9.6 vs 4.1; p=0.001). Functional MRI detected an increase in BOLD signal in the cerebellum, cuneus, and multiple frontal areas including the inferior, medial, and middle frontal gyri following TSCS. CONCLUSIONS: Patients that completed twelve weeks of TSCS experienced a significant reduction in perceived urge per void and urgency incontinence episodes and an increase in urge-free voids per 24 hours. ICIQ-OAB scores were significantly lower in patient’s post-spinal neuromodulation. TSCS resulted in a restoration of activation of several cortical brain regions. 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 David Chapman More articles by this author Luis Alejandro Morales Ojeda More articles by this author Veronica Stefania Montero Arcila More articles by this author Sarah Ponce More articles by this author Rita Jen More articles by this author Nhi Ha More articles by this author Parag Gad More articles by this author Reggie Edgerton More articles by this author David Ginsberg More articles by this author Aidin Abedi More articles by this author Kay Jann More articles by this author Evgeniy Kreydin More articles by this author Expand All Advertisement PDF downloadLoading ...