Neuromodulating Cortical Regions Involved in Neurogenic Bladder in MS (MSBLADDER)
Neurogenic Bladder, Multiple Sclerosis, Overactive Bladder
About this trial
This is an interventional treatment trial for Neurogenic Bladder focused on measuring Neurogenic bladder, Functional Neuroimaging, repetitive Transcranial Magnetic Stimulation (rTMS), Neuromodulation
Eligibility Criteria
Inclusion Criteria: Adult women (≥ 18 years of age) Clinically stable MS defined as ExpandedDisability Status Score (EDSS) ≤ 7.5without exacerbation worsening in the preceding 6 months prior to study entry Neurogenic Lower Urinary Tract Dysfunction symptoms ≥ 3 months with NBSS total ≥ 15 Individuals with Montreal Cognitive Assessment (MoCA) score >10 will be eligible At least one bladder storage symptoms (e.g., urinary frequency, urinary urgency, nocturia with or without incontinence) indicated by OAB -AT≥ 8 Individuals with active urinary tract infection (UTI) will be treated and will be enrolled after negative urinalysis Exclusion Criteria: Pregnant/planning to become pregnant or nursing Urodynamic findings of bladder outlet obstruction Baclofen or other intrathecal pumps, Pacemakers. History of seizure disorder (SZ), immediate family of SZ disorder, in addition to individuals who are taking any medications such as (bupropion) Wellbutrin or substances (ex: heavy alcohol use) that would lower seizure threshold will be excluded. History of bipolar disorder, or individuals who are taking medications that can exacerbate the condition such as tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin-nor-epinephrine reuptake inhibitors, anti-psychotics, lithium, bupropion (Wellbutrin) and antihistamines will be excluded. All intracranial lesions and hemorrhagic stroke will be excluded History of moderate to severe heart disease or unstable angina History of Autonomic Dysreflexia History of interstitial cystitis, pelvic radiation Intra-detrusor botulinumtoxinA (BTX-A) injection over the past 6 months Incarcerated patients will be excluded. Active sacral nerve stimulation (SNS) device or any other spinal stimulators Indwelling urethral or suprapubic catheter
Sites / Locations
- Houston Methodist HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Active Comparator
Sham Comparator
Active rTMS
Sham rTMS
1 Hz (LF) and 10 Hz (HF) rTMS stimulation will be delivered at 90% of the resting motor threshold for 40 min each week day for two weeks.
Low-frequency (1Hz) active rTMS stimulation will be delivered with an inert "sham" stimulation coil for 40 min each week day for two weeks.