Pd59-09 Near Infrared Spectroscopy (Nirs) Can Detect Acute Sacral Neuromodulation Adjustments in the Anterior Bladder Wall and the Prefrontal Cortex

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neuromodulation (PD59)1 May 2024PD59-09 NEAR INFRARED SPECTROSCOPY (NIRS) CAN DETECT ACUTE SACRAL NEUROMODULATION ADJUSTMENTS IN THE ANTERIOR BLADDER WALL AND THE PREFRONTAL CORTEX Linda S. Burkett, Alice Strawn, Brendan McCormack, Mina Ghatas, Luc Mortemousque, Justin Dare, Ryan W. Fogg, Lynn Stothers, John E. Speich, and Adam P. Klausner Linda S. BurkettLinda S. Burkett , Alice StrawnAlice Strawn , Brendan McCormackBrendan McCormack , Mina GhatasMina Ghatas , Luc MortemousqueLuc Mortemousque , Justin DareJustin Dare , Ryan W. FoggRyan W. Fogg , Lynn StothersLynn Stothers , John E. SpeichJohn E. Speich , and Adam P. KlausnerAdam P. Klausner View All Author Informationhttps://doi.org/10.1097/01.JU.0001009544.34256.8a.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Sacral neuromodulation (SNM) targets the S3 sacral nerve and the proposed mechanistic pathways link SNM effects on filling/voiding to neuroplasticity involving the prefrontal cortex (PFC) and bladder sympathetic control. The purpose of this study was to determine if non-invasive standard Near Infrared Spectroscopy (NIRS) and functional NIRS (fNIRS) could detect acute changes in SNM (OFF-ON) in anterior bladder wall hemodynamics and PFC neuroexcitation, respectively, during natural bladder filling. METHODS: Participants treated with SNM (implanted >6 months) with medication-refractory overactive bladder (OAB) completed a natural filling protocol using a Sensation Meter to record bladder sensation from 0-100% fullness. Continuous PFC and bladder oxyhemoglobin (O2Hb) were recorded, Fig 1a. Upon reporting "first desire to void", each patient's SNM unit was adjusted between OFF and ON (3-minute intervals) until 100% sensation (capacity). Surveys for urgency (ICIQ-OAB) and demographic variables were compared. RESULTS: A total of 10 device adjustment cycle pairs were completed with six women (mean age: 61.5±14.7 years and mean BMI: 33.0±10.8). The median time from implantation of SNM was 42 months and the mean total OAB score was 18.5±11.2. Anterior bladder wall O2Hb decreased or remained constant in 90% of OFF-ON cycles, Fig 1b. This demonstrates a slowing of the expected increasing oxygen requirement during filling. In all PFC brain regions, for most cycles, there was a deactivation of neural excitation from OFF-ON (Right 100%, Middle 70%, Left 80%). In 23/30 (77%) of OFF segments, there was increasing or stabilizing O2Hb. Therefore, SNM may potentially reduce O2Hb requirements in tissue during filling, Fig 1c. CONCLUSIONS: Standard NIRS and fNIRS application can detect changes in O2Hb during natural filling in the anterior bladder wall and PFC induced by acute SNM adjustments. These changes suggest SNM affects both the bladder and PFC in voiding control. When SNM was adjusted to ON, participants with OAB demonstrated consistent dampening of increasing O2Hb associated with urgency. Future confirmatory studies are needed, but this study shows that NIRS and fNIRS can potentially be developed to optimize SNM treatment. Download PPT Source of Funding: NIH-R21DK128649, NIH-K12HD108269 © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1224 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Linda S. Burkett More articles by this author Alice Strawn More articles by this author Brendan McCormack More articles by this author Mina Ghatas More articles by this author Luc Mortemousque More articles by this author Justin Dare More articles by this author Ryan W. Fogg More articles by this author Lynn Stothers More articles by this author John E. Speich More articles by this author Adam P. Klausner More articles by this author Expand All Advertisement PDF downloadLoading ...