TY - JOUR
T1 - Predictors for outcomes of noninvasive, individualized transcranial magnetic neuromodulation in multiple sclerosis women with neurogenic voiding dysfunction
AU - Jang, Yongchang
AU - Tran, Khue
AU - Shi, Zhaoyue
AU - Christof, Karmonik
AU - Choksi, Darshil
AU - Salazar, Betsy H.
AU - Lincoln, John A.
AU - Khavari, Rose
N1 - Funding Information:
We would like to thank Hamida Rajab for her effort during the recruitment and performance of the clinical trial. Additionally, we want to show our gratitude to Ms. Carlina Acosta for her assistance with UDS. This investigator-initiated study by Dr. Rose Khavari was supported in part through an award by the National Institute of Diabetes and Digestive and Kidney Diseases (1K23DK118209-01) and Houston Methodist Clinician Scientist Program. Research Involving Human Participants: This study was performed in line with the principles of the Declaration of Helsinki. Ethical approval was granted by the Institutional Review Board at Houston Methodist Hospital (PRO00019329) prior to conducting the research. Informed Consent: All participants signed an informed consent form to participate in the study and publish the results of the study.
Funding Information:
This investigator-initiated study by Dr. Rose Khavari was supported in part through an award by the National Institute of Diabetes and Digestive and Kidney Diseases ( 1K23DK118209-01 ) and Houston Methodist Clinician Scientist Program.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/12
Y1 - 2022/12
N2 - Purpose: Multiple sclerosis (MS) is a multifocal demyelinating disease that affects the central nervous system (CNS) and commonly leads to neurogenic lower urinary tract dysfunction (NLUTD). Proper storage and release of urine relies on synchronized activity of the LUT, which is meticulously regulated by supraspinal circuits, making it vulnerable to diseases such as MS. NLUTD, characterized by voiding dysfunction (VD), storage issues, or a combination of both is a common occurrence in MS. Unfortunately, there are limited treatment options for NLUTD, making the search for alternative treatments such as transcranial rotating permanent magnet stimulation (TRPMS) of utmost importance. To assess effectiveness of treatment we also need to understand underlying factors that may affect outcomes, which we addressed here. Methods: Ten MS subjects with VD and median age of 54.5 years received daily TRPMS sessions for two weeks. Five pre-determined regions of interest (ROIs) known to be involved in the micturition cycle were modulated (stimulated or inhibited) using TRPMS. Clinical data (non-instrumented uroflow and urodynamics parameters, PVR, bladder symptom questionnaires) and neuro-imaging data were collected at baseline and following TRPMS via 7-Tesla Siemens MAGNETOM Terra magnetic resonance imaging (MRI) scanner. Each participant underwent functional MRI (fMRI) concurrently with a repeated urodynamic study (UDS). Baseline data of each arm was evaluated to determine any indicators of successful response to treatment.
AB - Purpose: Multiple sclerosis (MS) is a multifocal demyelinating disease that affects the central nervous system (CNS) and commonly leads to neurogenic lower urinary tract dysfunction (NLUTD). Proper storage and release of urine relies on synchronized activity of the LUT, which is meticulously regulated by supraspinal circuits, making it vulnerable to diseases such as MS. NLUTD, characterized by voiding dysfunction (VD), storage issues, or a combination of both is a common occurrence in MS. Unfortunately, there are limited treatment options for NLUTD, making the search for alternative treatments such as transcranial rotating permanent magnet stimulation (TRPMS) of utmost importance. To assess effectiveness of treatment we also need to understand underlying factors that may affect outcomes, which we addressed here. Methods: Ten MS subjects with VD and median age of 54.5 years received daily TRPMS sessions for two weeks. Five pre-determined regions of interest (ROIs) known to be involved in the micturition cycle were modulated (stimulated or inhibited) using TRPMS. Clinical data (non-instrumented uroflow and urodynamics parameters, PVR, bladder symptom questionnaires) and neuro-imaging data were collected at baseline and following TRPMS via 7-Tesla Siemens MAGNETOM Terra magnetic resonance imaging (MRI) scanner. Each participant underwent functional MRI (fMRI) concurrently with a repeated urodynamic study (UDS). Baseline data of each arm was evaluated to determine any indicators of successful response to treatment.
KW - Magnetic resonance imaging
KW - Multiple sclerosis
KW - Neuromodulation
KW - Voiding dysfunction
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U2 - 10.1016/j.cont.2022.100517
DO - 10.1016/j.cont.2022.100517
M3 - Article
AN - SCOPUS:85166399060
SN - 2772-9737
VL - 4
JO - Continence
JF - Continence
M1 - 100517
ER -