Neuromodulation : journal of the International Neuromodulation Society · 2026
Evaluation of Functional Magnetic Stimulation Parameters and Effectiveness for Neurogenic Detrusor Overactivity: A Systematic Review and Network Meta-Analysis.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Pan Hongxia, Sun Xin, Zhu Liang, Ding Mingfu, Wei Quan
Аннотация
OBJECTIVES: This network meta-analysis (NMA) aimed to evaluate the comparative efficacy of different functional magnetic stimulation (FMS) protocols-including stimulation site, frequency, and duration-on urodynamic and symptom outcomes in patients with neurogenic detrusor overactivity (NDO), and to provide evidence-based guidance on treatment parameters.
MATERIALS AND METHODS: A systematic search was conducted across PubMed, Embase, Medline, Web of Science, Scopus, Ovid, CNKI, Chinese Biomedical Database, Wanfang, Weipu, and ClinicalTrials.gov up to October 20, 2023. Randomized controlled trials (RCTs) involving patients with NDO secondary to neurologic disorders and reporting urodynamic or symptom outcomes (including maximum cystometric capacity [MCC], daily urinary incontinence [UI] episodes, Pvesmax, volume at first desire to void [FDV], postvoid residual urine volume [PVR], average voided volume [AVV], etc) were included. Interventions included any FMS protocol, including repetitive transcranial magnetic stimulation (TMS), repetitive transpinal magnetic stimulation (rTSMS), and repetitive sacral magnetic stimulation (SMS). Safety outcomes, including adverse events, also were considered.
RESULTS: The study included 20 RCTs involving 1316 participants, and all trials were used for the meta-analysis. SMS significantly improved MCC (MD: 31.94 mL; 95% CI, 8.18-55.71), and reduced PVR (MD: 24.33 mL; 95% CI, -42.89 to -5.77) vs control. TMS decreased FDV (MD: -59.70 mL; 95% CI, -96.45 to -22.95). Among the frequencies evaluated, 15 Hz produced the largest improvement in MCC (+39.41 mL; 95% CI, 15.09-63.74), ranking highest among tested frequencies. An eight-week regimen achieved the greatest MCC improvement (+46.16 mL; 95% CI, 11.79-80.51) and ranked highest by p-score among the treatment durations evaluated. SMS was superior for reducing daily UI episodes (Surface Under the Cumulative Ranking curve: 0.86).
CONCLUSIONS: FMS, particularly SMS, significantly improves bladder storage capacity and reduces incontinence in patients with NDO. Among evaluated parameters, 15-Hz stimulation and an eight-week regimen were associated with the greatest improvements in MCC; however, these parameters were analyzed independently, and evidence regarding their combined effects or interactions across stimulation sites is limited. TMS showed mixed effects, increasing AVV but decreasing FDV, suggesting enhanced bladder sensitivity rather than improved storage. These findings indicate that SMS has the most favorable profile among single-parameter comparisons, but further studies are needed to evaluate combinations of stimulation site, frequency, and duration, in addition to individualized treatment strategies for NDO.
MATERIALS AND METHODS: A systematic search was conducted across PubMed, Embase, Medline, Web of Science, Scopus, Ovid, CNKI, Chinese Biomedical Database, Wanfang, Weipu, and ClinicalTrials.gov up to October 20, 2023. Randomized controlled trials (RCTs) involving patients with NDO secondary to neurologic disorders and reporting urodynamic or symptom outcomes (including maximum cystometric capacity [MCC], daily urinary incontinence [UI] episodes, Pvesmax, volume at first desire to void [FDV], postvoid residual urine volume [PVR], average voided volume [AVV], etc) were included. Interventions included any FMS protocol, including repetitive transcranial magnetic stimulation (TMS), repetitive transpinal magnetic stimulation (rTSMS), and repetitive sacral magnetic stimulation (SMS). Safety outcomes, including adverse events, also were considered.
RESULTS: The study included 20 RCTs involving 1316 participants, and all trials were used for the meta-analysis. SMS significantly improved MCC (MD: 31.94 mL; 95% CI, 8.18-55.71), and reduced PVR (MD: 24.33 mL; 95% CI, -42.89 to -5.77) vs control. TMS decreased FDV (MD: -59.70 mL; 95% CI, -96.45 to -22.95). Among the frequencies evaluated, 15 Hz produced the largest improvement in MCC (+39.41 mL; 95% CI, 15.09-63.74), ranking highest among tested frequencies. An eight-week regimen achieved the greatest MCC improvement (+46.16 mL; 95% CI, 11.79-80.51) and ranked highest by p-score among the treatment durations evaluated. SMS was superior for reducing daily UI episodes (Surface Under the Cumulative Ranking curve: 0.86).
CONCLUSIONS: FMS, particularly SMS, significantly improves bladder storage capacity and reduces incontinence in patients with NDO. Among evaluated parameters, 15-Hz stimulation and an eight-week regimen were associated with the greatest improvements in MCC; however, these parameters were analyzed independently, and evidence regarding their combined effects or interactions across stimulation sites is limited. TMS showed mixed effects, increasing AVV but decreasing FDV, suggesting enhanced bladder sensitivity rather than improved storage. These findings indicate that SMS has the most favorable profile among single-parameter comparisons, but further studies are needed to evaluate combinations of stimulation site, frequency, and duration, in addition to individualized treatment strategies for NDO.