Neuromodulatory effects of repetitive transcranial magnetic stimulation on post-stroke urinary retention: insights from neuroelectrophysiological assessment.

BACKGROUND

Post-stroke urinary retention is common and clinically relevant. Repetitive transcranial magnetic stimulation (rTMS) may modulate supraspinal micturition circuits, but evidence in retention is limited.

METHODS

We retrospectively studied 103 patients with post-stroke urinary retention: 52 received 4 weeks of contralesional M1 low-frequency rTMS plus rehabilitation, and 51 rehabilitation alone. Outcomes included post-void residual volume (PVR) and neurophysiological measures, while the urinary function score was analyzed as an exploratory symptom measure.

RESULTS

Most baseline characteristics were similar between groups. Compared with controls, the rTMS group showed greater reductions in PVR (- 30 vs. - 10 ml at week 2; -64 vs. - 17 ml at week 4, p < 0.001), exploratory improvements in urinary function scores (- 6.1 vs. - 2.1, p < 0.001), shorter reflex latency (- 14.4 vs. - 5.0 ms, p < 0.001), and higher EMG amplitude (+ 23.4 vs. + 2.5 µV, p < 0.001).

CONCLUSIONS

In this retrospective cohort, low-frequency rTMS was associated with improved bladder emptying and neurophysiological changes in post-stroke urinary retention.