Brain Response Induced by Peroneal Electrical Transcutaneous Neuromodulation Invented for Overactive Bladder Treatment, as Detected by Functional Magnetic Resonance Imaging.

In this study, we aimed to investigate whether peroneal electrical Transcutaneous Neuromodulation invented for overactive bladder (OAB) treatment elicits activation in brain regions involved in neural regulation of the lower urinary tract.

Among 22 enrolled healthy female volunteers, 13 were eligible for the final analysis. Functional magnetic resonance imaging (fMRI) (Siemens VIDA 3T; Erlangen, Germany) was used to compare the brain region activation elicited by peroneal electrical Transcutaneous Neuromodulation with the activation elicited by sham stimulation. Each subject underwent brain fMRI recording during eight 30-second periods of rest, alternating with 30-second periods of passive feet movement using the sham device, mimicking the motor response to peroneal nerve stimulation. Subsequently, fMRI recording was performed during the analogic "off-on" stimulation paradigm using peroneal electrical transcutaneous neuromodulation. Magnetic resonance imaging data acquired during both paradigms were compared using individual and group statistics.

During both peroneal electrical Transcutaneous Neuromodulation and sham feet movements, we observed activation of the primary motor cortex and supplementary motor area, corresponding to the cortical projection of lower limb movement. During peroneal electrical Transcutaneous Neuromodulation, we observed significant activations in the brain stem, cerebellum, cingulate gyrus, putamen, operculum, and anterior insula, which were not observed during the sham feet movement.

Our study provides evidence that peroneal electrical Transcutaneous Neuromodulation elicits activation of brain structures that have been previously implicated in the perception of bladder fullness and that play a role in the ability to cope with urinary urgency. Our data suggest that neuromodulation at the level of supraspinal control of the lower urinary tract may contribute to the treatment effect of peroneal electrical Transcutaneous Neuromodulation in patients with OAB.

Neuromodulation : journal of the International Neuromodulation Society. 2023 Jan 02 [Epub ahead of print]

Jan Krhut, Jaroslav Tintěra, Michal Rejchrt, Barbora Skugarevska, Michal Grepl, Roman Zachoval, Peter Zvara, Bertil F M Blok

Department of Urology, University Hospital, Ostrava, Czech Republic; Department of Surgical Studies, Ostrava University, Ostrava, Czech Republic. Electronic address: ., Department of Radiodiagnostics and Interventional Radiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic., Department of Urology, Second Faculty of Medicine of Charles University and Motol University Hospital, Prague, Czech Republic., Department of Urology, University Hospital, Ostrava, Czech Republic; Department of Surgical Studies, Ostrava University, Ostrava, Czech Republic., Department of Urology, First Faculty of Medicine of Charles University and Thomayer Hospital, Prague, Czech Republic., Biomedical Laboratory and Research Unit of Urology, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Urology, Odense University Hospital, Odense, Denmark., Department of Urology, Erasmus Medical Center, Rotterdam, the Netherlands.

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