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Transcranial magnetic stimulation and bladder function: A systematic review.

Raffaele Nardone1, Viviana Versace2, Luca Sebastianelli2

  • 1Department of Neurology, Franz Tappeiner Hospital, Merano, Italy; Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Spinal Cord Injury and Tissue Regeneration Center, Salzburg, Austria; Karl Landsteiner Institut für Neurorehabilitation und Raumfahrtneurologie, Salzburg, Austria.

Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology
|September 22, 2019
PubMed
Summary
This summary is machine-generated.

Motor evoked potentials (MEPs) show limited clinical use for pelvic floor muscles, but repetitive transcranial magnetic stimulation (rTMS) shows promise for neurogenic bladder dysfunction and pelvic pain.

Keywords:
BladderLower urinary tract dysfunctionMicturitionMotor evoked potentialsPelvic floorSphinctersTranscranial magnetic stimulation

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Area of Science:

  • Neuroscience
  • Urology
  • Rehabilitation Medicine

Background:

  • Assessing pelvic floor motor innervation is crucial for diagnosing and managing urologic disorders.
  • Neurogenic bladder dysfunction significantly impacts quality of life.

Purpose of the Study:

  • To evaluate the utility of motor evoked potentials (MEPs) for assessing pelvic floor innervation.
  • To explore the role of repetitive transcranial magnetic stimulation (rTMS) in treating neurogenic bladder dysfunction.

Main Methods:

  • Systematic literature search of PubMed and Embase databases.
  • Review and synthesis of 11 relevant articles.

Main Results:

  • MEPs demonstrated poor reproducibility for pelvic floor muscles, questioning their clinical applicability.
  • High-frequency rTMS may improve detrusor contraction and sphincter relaxation in multiple sclerosis patients.
  • Low-frequency rTMS shows potential for treating neurogenic lower urinary tract dysfunction in Parkinson's disease and other neurodegenerative disorders.

Conclusions:

  • MEPs have questionable clinical utility for pelvic floor muscle assessment due to reproducibility issues.
  • rTMS is an emerging treatment for neurogenic bladder dysfunction, showing promise for various conditions including spinal cord injury and bladder pain syndrome.
  • Further randomized controlled studies with larger sample sizes are needed to validate rTMS efficacy.