Low-frequency tibial neuromodulation excites bladder activity in humans
Despite widespread clinical adoption for disorders of incontinence such as overactive bladder, there remain unknowns surrounding the mechanism that underpins tibial nerve stimulation (TNS). Current understanding suggests that TNS counteracts incontinence by the inhibition of brainstem and spinal cord activity. How this inhibition alters bladder function is not fully understood. We hypothesize…
Research has unveiled a novel aspect of tibial nerve stimulation (TNS) in treating overactive bladder. The study suggests that TNS can both inhibit and excite bladder activity, depending on the frequency of the stimulation. The hypothesis posits that TNS operates as a high-pass filter, permitting bladder signals only when the urinary bladder is sufficiently filled.
This hypothesis was tested through a single-blinded trial involving healthy human participants who were subjected to high- and low-frequency transcutaneous TNS. Additionally, a computational model of the lower urinary tract and control circuits was developed to study the frequency-dependent effects of TNS. The results revealed a frequency-dependent impact of TNS, enabling it to modify urge perception and regulate bladder activity.
This discovery corroborates the predictions made by the model, offering a foundation for the creation of targeted and efficient TNS therapies. The findings suggest that low-frequency TNS might serve as a non-invasive treatment option for urinary retention, prompting further clinical research to ascertain its efficacy.
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