[Transcutaneous tibial nerve stimulation in the overactive bladder syndrome in patients with Parkinson's syndromes]

Abstract

Objectives: To evaluate the efficacy of chronic transcutaneous tibial nerve stimulation (TNS) on overactive bladder syndrome in female patients with Parkinson's disease (PD) and multiple system atrophy (MSA).

Patients and methods: A prospective monocentric study enrolled six female patients with PD or MSA suffering from overactive bladder syndrome for a six-week study period. Daily sessions of 20 minutes of TNS were provided. The primary outcome measurement was the Patient Global Impression of Improvement (PGI-I scale). The secondary outcomes measurements were symptom and quality of life scores, bladder diary and urodynamics. The outcomes after 6 weeks of TNS were compared to baseline.

Results: TNS was considered as an effective treatment by five patients out of six (83%) who ask to pursue the treatment and were still doing it 6 months after the end of the study. A trend improvement was observed in only two of the secondary evaluation criteria the V8 median score 21/40 to 14/40 (P=0.2) and the maximum cystometric capacity increased from 211 mL ± 106 to 260 mL ± 226 (P=0.6) after SNT.

Conclusion: Although urodynamics and symptoms scores did not show significant difference, an efficacy of TNS on overactive bladder in PD and MSA is possible. Additional placebo controlled works enrolling more patients are required to ensure these preliminary results.

Keywords: Atrophie multisystématisée; Hyperactivité vésicale; Incontinence; Incontinence urinaire; Maladie de Parkinson; Multiple system atrophy; Neurogenic bladder; Neurostimulation tibiale; Overactive bladder; Parkinson disease; Transcutaneous tibial nerve stimulation; Vessie neurologique.