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Noninvasive, Individualized Cortical Modulation Using Transcranial Rotating Permanent Magnet Stimulator for Voiding

Rose Khavari1, Khue Tran1, Santosh A Helekar2,3

  • 1Department of Urology, Houston Methodist Hospital, Houston, Texas.

The Journal of Urology
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Summary

This study shows Transcranial Rotating Permanent Magnet Stimulator (TRPMS) safely improved bladder emptying in women with multiple sclerosis (MS) and voiding dysfunction (VD). TRPMS modulated brain activity related to urination, offering a new therapeutic approach for MS-related VD.

Keywords:
magnetic resonance imagingmultiple sclerosis

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Area of Science:

  • Neuroscience
  • Urology
  • Medical Devices

Background:

  • Voiding dysfunction (VD) is a common neurogenic lower urinary tract symptom in multiple sclerosis (MS) patients.
  • Current management for MS-related VD primarily involves catheterization.
  • Noninvasive neuromodulation offers a potential alternative for managing complex neurological conditions.

Purpose of the Study:

  • To investigate the safety and therapeutic effects of Transcranial Rotating Permanent Magnet Stimulator (TRPMS) in MS women with VD.
  • To assess TRPMS's ability to modulate brain regions involved in voiding initiation.
  • To determine if TRPMS can improve clinical symptoms of bladder emptying in MS patients.

Main Methods:

  • A pilot trial involving ten MS women with VD, assessed using concurrent functional magnetic resonance imaging/urodynamic study (fMRI/UDS).
  • Patients received 10 consecutive 40-minute TRPMS treatment sessions.
  • Brain activation, uroflow, and validated questionnaires were compared pre- and post-treatment.

Main Results:

  • No treatment-related adverse effects were reported.
  • Significant increases in brain activation within regions associated with voiding initiation were observed post-treatment.
  • % post-void residual/bladder capacity decreased significantly, and patients reported improved bladder emptying symptoms.

Conclusions:

  • TRPMS effectively and safely modulated brain regions involved in the micturition cycle in MS patients.
  • Neuroimaging and clinical data support TRPMS as a promising therapeutic option for MS-related VD.
  • This pilot study suggests TRPMS can lead to significant clinical improvements in bladder emptying for MS patients.