Medications used to treat bladder disorders may alter effects of neuromodulation

Ness, Timothy J.; McNaught, Jamie; Clodfelder‐Miller, Buffie; Su, Xin

doi:10.1002/nau.24373

Cited by 9 publications

(9 citation statements)

References 24 publications

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“…To date, we and others have identified that some of these possibilities have an anatomic and/or physiological basis and may involve subsets of bladder afferents (48,49). For purposes of the present set of studies, it is sufficient to say that various optimal parameters related to NBI treatments have been defined and should be utilized in future studies attempting to delineate the mechanisms of NBI-induced sensitization (50)(51)(52)(53)(54).…”

Section: Discussionmentioning

confidence: 99%

A Model in Female Rats With Phenotypic Features Similar to Interstitial Cystitis/Bladder Pain Syndrome

et al. 2021

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This report describes methodological and exploratory investigations of the zymosan-induced neonatal bladder inflammation (NBI) model of interstitial cystitis/bladder pain syndrome (IC/BPS) in female rats. These results validate and extend the currently employed model by evaluating critical timepoints for obtaining treatment effects and identified that a second insult as an adult including repeat intravesical zymosan, intravesical lipopolysaccharide, acute footshock stress, neuropathic nociception (facial) or somatic inflammation (hindpaw) all resulted in magnified visceromotor responses to urinary bladder distension (UBD) in rats which had experienced NBI when compared with their controls. NBI also resulted in increased tone and reactivity of pelvic floor musculature to UBD, as well as increased responsiveness to intravesical potassium chloride solutions, abnormal anxiety measures (elevated plus maze) and an increased number of submucosal petechial hemorrhages following 30 min of hydrodistension of the bladder. These phenotypic findings have correlates to the clinical features of IC/BPS in humans and so support use of this model system to examine mechanisms of and treatments for IC/BPS.

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Section: Discussionmentioning

confidence: 99%

A Model in Female Rats With Phenotypic Features Similar to Interstitial Cystitis/Bladder Pain Syndrome

et al. 2021

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“…The clinical application of TNS is potentially limited in patients with alterations of the central nervous pathways including spinal cord, brainstem, and cortical areas due to the demonstrated central nervous interaction. The alertness of the central nervous system might be influenced by specific medications (e.g., antidepressant or other medications with proven central nervous side effects) and thus might influence the processing of afferent and efferent neuronal inputs (e.g., urge to void, voiding, electrical neuromodulation) 14,15 . This shall be addressed and considered in the design of future research.…”

Section: Discussionmentioning

confidence: 99%

“…The alertness of the central nervous system might be influenced by specific medications (e.g., antidepressant or other medications with proven central nervous side effects) and thus might influence the processing of afferent and efferent neuronal inputs (e.g., urge to void, voiding, electrical neuromodulation). 14,15 This shall be addressed and considered in the design of future research.…”

Section: Implication For Clinical Practicementioning

confidence: 99%

Identification of brain functional connectivity during acute transcutaneous tibial nerve stimulation: A 3T fMRI study

Wöllner,

Krebs,

Richter

et al. 2023

Neurourology and Urodynamics

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ObjectivesA feasibility proof‐of‐concept study was conducted to assess the effects of acute tibial nerve stimulation (TNS) on the central nervous system in healthy volunteers using functional magnetic resonance imaging (fMRI).Materials and MethodsFourteen healthy volunteers were included in a prospective, single‐site study conducted on a clinical 3T MRI scanner. Four scans of functional MRI, each lasting 6 min, were acquired: two resting‐state fMRI scans (prior and following the TNS intervention) and in‐between two fMRI scans, both consisting of alternating rest periods and noninvasive acute transcutaneous TNS (TTNS). Whole brain seed‐based functional connectivity (FC) correlation analysis was performed comparing TTNS stimulation with rest periods. Cluster‐level familywise error (FWE) corrected p and a minimal cluster size of 200 voxels were used to explore FC patterns.ResultsIncreased FC is reported between inferior frontal gyrus, posterior cingulate gyrus, and middle temporal gyrus with the precuneus as central receiving node. In addition, decreased FC in the cerebellum, hippocampus, and parahippocampal areas was observed.ConclusionsAltered FC is reported in areas which have been described to be also involved in lower urinary tract control. Although conducted with healthy controls, the assumption that the underlying therapeutic effect of TNS involves the central nervous system is supported and has to be further examined in patients with incomplete spinal cord injury.

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“…Used mainly for the treatment of muscle spasticity, it has also found a role in the treatment of neuropathic pain [ 2 – 4 ]. Recent experiments reported by ourselves [ 5 ] which assessed the effects of commonly employed adjuvant agents on peripheral nerve stimulation-related neuromodulation identified that baclofen may have an analgesic effect on bladder nociception. However, the rats used in those particular experiments had extensive surgeries and received numerous other manipulations.…”

Section: Introductionmentioning

confidence: 99%

Systemic and intrathecal baclofen produce bladder antinociception in rats

Ness

Randich

et al. 2021

BMC Urol

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Background Baclofen, a clinically available GABAB receptor agonist, produces non-opioid analgesia in multiple models of pain but has not been tested for effects on bladder nociception. Methods A series of experiments examined the effects of systemic and spinally administered baclofen on bladder nociception in female anesthetized rats. Models of bladder nociception included those which employed neonatal and adult bladder inflammation to produce bladder hypersensitivity. Results Cumulative intraperitoneal dosing (1–8 mg/kg IP) and cumulative intrathecal dosing (10–160 ng IT) of baclofen led to dose-dependent inhibition of visceromotor responses (VMRs) to urinary bladder distension (UBD) in all tested models. There were no differences in the magnitude of the analgesic effects of baclofen as a function of inflammation versus no inflammation treatments. Hemodynamic (pressor) responses to UBD were similarly inhibited by IT baclofen as well as UBD-evoked excitatory responses of spinal dorsal horn neurons. The GABAB receptor antagonist, CGP 35,348, antagonized the antinociceptive effects of IT baclofen on VMRs in all tested models but did not affect the magnitude of the VMRs by itself suggesting no tonic GABAB activity was present in this preparation. Tolerance to a seven day continuous IT infusion of baclofen was not observed. Conclusions These data provide support for a clinical trial of baclofen as a non-opioid treatment of human bladder pain.

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Medications used to treat bladder disorders may alter effects of neuromodulation

Cited by 9 publications

References 24 publications

A Model in Female Rats With Phenotypic Features Similar to Interstitial Cystitis/Bladder Pain Syndrome

A Model in Female Rats With Phenotypic Features Similar to Interstitial Cystitis/Bladder Pain Syndrome

Identification of brain functional connectivity during acute transcutaneous tibial nerve stimulation: A 3T fMRI study

Systemic and intrathecal baclofen produce bladder antinociception in rats

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