Transcutaneous Electrical Nerve Stimulation of Lower Leg Afferents for the Potential Treatment of Overactive Bladder

Transcutaneous electrical nerve stimulation (TENS) has been used as a neuromodulation therapy for overactive bladder (OAB). There has been limited efficacy shown with non-invasive neuromodulation therapies compared to percutaneous tibial nerve stimulation. TENS therapy has been explored as using the tibial nerve, but preclinical data suggests that during tibial nerve stimulation there is coactivation of the saphenous nerve and that the plantar nerves may be better nerve targets. The goal of this research is to characterize the selective activation of lower leg afferents when stimulated with TENS and to determine the therapeutic efficacy of stimulating the saphenous nerve with TENS for OAB therapy. The clinical studies in this research suggest that the saphenous may be a good nerve target for therapy and its efficacy is explored. Based on these findings, TENS may provide patients with a convenient at-home treatment for OAB allowing them to manage their symptoms.M.H.Sc

Characterizing the transcutaneous electrical recruitment of lower leg afferents in healthy adults: implications for non-invasive treatment of overactive bladder

Abstract Background As a potential new treatment for overactive bladder (OAB), we investigated the feasibility of non-invasively activating multiple nerve targets in the lower leg. Methods In healthy participants, surface electrical stimulation (frequency = 20 Hz, pulse width = 200 μs) was used to target the tibial nerve, saphenous nerve, medial plantar nerve, and lateral plantar nerve. At each location, the stimulation amplitude was increased to define the thresholds for evoking (1) cutaneous sensation, (2) target nerve recruitment and (3) maximum tolerance. Results All participants were able to tolerate stimulation amplitudes that were 2.1 ± 0.2 (range = 2.0 to 2.4) times the threshold for activating the target nerve. Conclusions Non-invasive electrical stimulation can activate neural targets at levels that are consistent with evoking bladder-inhibitory reflex mechanisms. Further work is needed to test the clinical effects of stimulating one or more neural targets in OAB patients

Additional file 1: of Characterizing the transcutaneous electrical recruitment of lower leg afferents in healthy adults: implications for non-invasive treatment of overactive bladder

Questionnaire.doc. Visual analog scale and anatomical maps. This questionnaire was provided to each participant to quantitatively measure the sensation of TENS and the physical spread of stimulation-evoked sensation as the amplitude was increased. (DOCX 357 kb

Additional file 2: of Characterizing the transcutaneous electrical recruitment of lower leg afferents in healthy adults: implications for non-invasive treatment of overactive bladder

Raw Data.xlsx. Summary of raw data obtained from each participant that characterized the stimulation threshold values (Raw Data tab) and the visual analogue scale values (Comfort Ratings tab). (XLSX 17 kb