You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction (PD36)1 Sep 2021PD36-02 PRELIMINARY RESULTS OF NOVEL, NONINVASIVE, INDIVIDUALIZED CORTICAL MODULATION USING TRANSCRANIAL ROTATING PERMANENT MAGNET STIMULATOR IN IMPROVING VOIDING DYSFUNCTION IN MULTIPLE SCLEROSIS WOMEN Khue Tran, Zhaoyue Shi, Christof Karmonik, Timothy Boone, Santosh A. Helekar, and Rose Khavari Khue TranKhue Tran More articles by this author , Zhaoyue ShiZhaoyue Shi More articles by this author , Christof KarmonikChristof Karmonik More articles by this author , Timothy BooneTimothy Boone More articles by this author , Santosh A. HelekarSantosh A. Helekar More articles by this author , and Rose KhavariRose Khavari More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002040.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Voiding dysfunction (VD) leading to urinary retention is a common neurogenic lower urinary tract dysfunction (NLUTD) in multiple sclerosis (MS) patients. Currently, the only effective management for MS patients with VD is catheterization, urging us to look into other therapeutic options. Transcranial rotating permanent magnet stimulator (TRPMS) is a noninvasive, multifocal neuromodulator that simultaneously modulates multiple cortical regions and the strength of their functional connections. In this pilot clinical trial (ClinicalTrials.gov NCT03574610), we investigated the therapeutic effects of TRPMS in modulating brain regions of interest (ROI) engaged with voiding initiation to improve VD in MS women. METHODS: Nine MS women with NLUTD and VD [defined as having %post-void residual/bladder capacity (%PVR/BC) ≥ 40% or being in the lower 10th percentile of the Liverpool nomogram] underwent concurrent functional magnetic resonance imaging/urodynamic (fMRI/UDS) evaluation (with three cycles of bladder filling/emptying) at baseline and post-treatment. Predetermined ROI (Figure 1A) and their activation at voiding initiation were identified on patients’ baseline fMRI/UDS scans. Microstimulators were placed on the TRPMS cap corresponding to ROI to either stimulate or inhibit them. Patients received ten 40-minute treatment sessions (Figure 1B). Brain activation group analysis, non-instrumented uroflow, and validated questionnaires were collected and compared at baseline and post-treatment. RESULTS: After treatment, patients showed significantly increased activation in brain regions known to be involved at voiding initiation in healthy subjects (Figure 1C). %PVR/BC significantly decreased. Significant improvement of bladder emptying and voiding symptoms were reported by patients via validated questionnaires. No treatment-related adverse effect was reported. CONCLUSIONS: Significant improvements in both neuroimaging and clinical data suggested that TRPMS was able to effectively and safely modulate cortical regions, enhancing activation of modulated and other brain regions that are involved in micturition and leading to clinical improvements in bladder emptying in MS women. Source of Funding: Dr. Khavari reports that she is partially supported by K23DK118209, by National Institute of Heath, NIDDK (RK). Also supported by Houston Methodist Clinician Scientist Award (RK) © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e595-e596 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Khue Tran More articles by this author Zhaoyue Shi More articles by this author Christof Karmonik More articles by this author Timothy Boone More articles by this author Santosh A. Helekar More articles by this author Rose Khavari More articles by this author Expand All Advertisement Loading ...