Introduction
Recent findings suggest that key areas in the brain, particularly the medial prefrontal cortex (mPFC), are important for regulating bladder function. This research explores the potential of transcranial direct current stimulation (tDCS) on the mPFC as an emerging approach to alleviate overactive bladder (OAB) symptoms, in comparison to transcutaneous tibial nerve stimulation (TTNS).
Methods
This single-blind, two-arm, parallel, randomized controlled clinical trial with a 1:1 allocation ratio was conducted at Firoozgar Hospital. A total of forty-four women diagnosed with overactive bladder (OAB) were randomly divided into two groups: one group received tDCS (transcranial Direct Current Stimulation) combined with PFMT (Pelvic Floor Muscle Training), and the other received TTNS(Trancutaneous Tibial Nerve Stimulation) combined with PFMT. The primary outcome measure was the quality of life through the International Consultation on Incontinence Questionnaire Lower Urinary Tract Symptoms Quality of Life Module (ICIQ-LUTSqol). Secondary outcome measures included the International Consultation on Incontinence Questionnaire Overactive Bladder Module (ICIQ-OAB), a three-day bladder diary, and assessment of pelvic floor muscle strength using a perineometer.
Results
Both groups exhibited improvements in OAB symptoms; however, the tDCS group appeared to show greater reductions in ICIQ-OAB scores and symptom bother (p < 0.05). As measured by the ICIQ-LUTSqol questionnaire, quality of life improved in both groups, with indications of comparatively greater improvements in the tDCS group after treatment and at the one-month follow-up (p = 0.05 and p < 0.05 respectively). Moreover, the number of urinary incontinence episodes tended to decline more markedly in the tDCS group, and this improvement was sustained during the follow-up period (p < 0.05).
Conclusion
This study’s findings suggest that while both TTNS and tDCS may effectively improve the quality of life in women with overactive bladder (OAB), the improvements observed in the tDCS group appear to be greater. However, further sham-controlled studies are needed to confirm these potential benefits.
Trial registration
Iranian Registry of Clinical Trials (IRCT) ID: IRCT20090301001722N26, date of registration: 17 May 2023. https://en.irct.ir/
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