rTMS in Overactive Bladder

Description

Overactive bladder (OAB) imposes a significant quality of life, mental health, and economic burdens. OAB with or without Urgency incontinence is associated with depression, sexual dysfunction, and limitation of social interactions and physical activities, which significantly affects quality of life. Non-invasive neuromodulation with repetitive transcranial magnetic stimulation (rTMS) can be used in research settings to investigate responses to focal regional brain activation. In the clinical setting, rTMS normalizes brain activity with associated clinical benefits in conditions such as refractory depression. rTMS has been studied for effects on lower urinary tract symptoms (LUTS) in bladder pain and neurogenic lower urinary tract symptoms (LUTS) populations. Unlike many standard of care OAB interventions, the safety of rTMS is well-reported, including for use in elderly populations and those with cognitive impairment. Functional magnetic resonance imaging (fMRI) to evaluate neuroplasticity is emerging as an essential tool to define OAB phenotypes; however, phenotyping studies guided by mechanistic data are lacking. The effects of central neuromodulation on regions involved OAB mechanisms and associated physiological and clinical responses are unknown. This study will be the first to report neuroplasticity, physiologic, and clinical effects of central neuromodulation with rTMS in adults with OAB.

Conditions

Overactive Bladder, Overactive Bladder Syndrome, Urge Incontinence, Urgency-frequency Syndrome, Urinary Incontinence, Urinary Incontinence, Urge

Study Overview

Study Details

Study overview

Overactive bladder (OAB) imposes a significant quality of life, mental health, and economic burdens. OAB with or without Urgency incontinence is associated with depression, sexual dysfunction, and limitation of social interactions and physical activities, which significantly affects quality of life. Non-invasive neuromodulation with repetitive transcranial magnetic stimulation (rTMS) can be used in research settings to investigate responses to focal regional brain activation. In the clinical setting, rTMS normalizes brain activity with associated clinical benefits in conditions such as refractory depression. rTMS has been studied for effects on lower urinary tract symptoms (LUTS) in bladder pain and neurogenic lower urinary tract symptoms (LUTS) populations. Unlike many standard of care OAB interventions, the safety of rTMS is well-reported, including for use in elderly populations and those with cognitive impairment. Functional magnetic resonance imaging (fMRI) to evaluate neuroplasticity is emerging as an essential tool to define OAB phenotypes; however, phenotyping studies guided by mechanistic data are lacking. The effects of central neuromodulation on regions involved OAB mechanisms and associated physiological and clinical responses are unknown. This study will be the first to report neuroplasticity, physiologic, and clinical effects of central neuromodulation with rTMS in adults with OAB.

Higher Neural and Clinical Effects of Non-Invasive Transcranial Neuromodulation in Adults With Overactive Bladder

rTMS in Overactive Bladder

Condition
Overactive Bladder
Intervention / Treatment

-

Contacts and Locations

Houston

Houston Methodist Hospital, Houston, Texas, United States, 77030

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Females \& Males
  • * 40 to 80 years old
  • * 3 months of OAB symptoms without active urinary tract infection currently
  • * Bladder diary:
  • * Mean voids/24 hours ≥ 8.0
  • * Mean urgency episodes/24 hours ≥ 3.0
  • * Montreal Cognitive Assessment (MoCA) score \>10
  • * Pregnant, nursing, or self-report of planning to become pregnant.
  • * Contraindication to MRI or to the Rapid2 Magstim Device as listed in the operator manual
  • * Qmax \< 10 ml/s in males on uroflow
  • * \< 20th percentile on Liverpool nomogram
  • * Postvoid residual volume ≥ 200 mL, suprapubic or indwelling catheter
  • * Personal or immediate family history of seizure disorder
  • * Taking (bupropion) Wellbutrin or heavy alcohol use
  • * Parkinson's disease, Multiple sclerosis, spinal cord injury
  • * Intracranial lesions and hemorrhagic stroke within the last 12 months
  • * History of interstitial cystitis, pelvic radiation, bladder augmentation
  • * Intradetrusor botulinum toxin injections within 6 months
  • * Pelvic floor therapy within 2 months.
  • * Active/on-mode Sacral nerve stimulator (eligible if turned off)
  • * Incarcerated patients

Ages Eligible for Study

40 Years to 80 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

The Methodist Hospital Research Institute,

Michelle Almarez, BBA, STUDY_DIRECTOR, Houston Methodist Obstetrics & Gynecology Department

Study Record Dates

2026-07