Livio Mordasini1, Thomas M Kessler2, Bernhard Kiss3, Michael Schüpbach4, Claudio Pollo5, Alain Kaelin-Lang6. 1. Department of Urology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland. Electronic address: livio.mordasini@kssg.ch. 2. Neuro-Urology, Spinal Cord Injury Center & Research, University of Zürich, Balgrist University Hospital, Zürich, Switzerland. Electronic address: tkessler@gmx.ch. 3. Department of Urology, University of Bern, Bern, Switzerland. Electronic address: bernhard.kiss@insel.ch. 4. Movement Disorders Center, Department of Neurology, University of Bern, Bern, Switzerland. Electronic address: michael.schuepbach@insel.ch. 5. Department of Neurosurgery, University of Bern, Bern, Switzerland. Electronic address: claudio.pollo@insel.ch. 6. Neurocenter of Southern Switzerland, Lugano, Switzerland. Electronic address: alain.kaelin@eoc.ch.
Abstract
INTRODUCTION: Neurogenic bladder dysfunction is well described in Parkinson's disease and has a major impact on quality of live. In contrast, little is known about the extent of urinary symptoms in other movement disorders such as dystonia and about the role of the basal ganglia in bladder control.. PATIENTS AND METHODS: A consecutive series of 11 patients with severe dystonia undergoing deep brain stimulation (DBS) of the globus pallidus internus was prospectively enrolled. Bladder function was assessed by the International Prostate Symptom Score and urodynamic investigation (UDI) before DBS surgery and afterwards in the conditions with and without DBS. RESULTS: In UDI before DBS surgery, detrusor overactivity was found in 36% (4/11) of dystonia patients. With pallidal DBS ON, maximum flow rate significantly decreased, post-void residual significantly increased and detrusor overactivity disappeared.. CONCLUSIONS: Pathological urodynamic changes can be found in a relevant percentage of dystonia patients. Pallidal DBS has a relaxing effect on detrusor function indicating a role of the basal ganglia in lower urinary tract control. Thus, a better understanding on how subcortical networks influence lower urinary tract function might open new therapeutic perspectives..
INTRODUCTION:Neurogenic bladder dysfunction is well described in Parkinson's disease and has a major impact on quality of live. In contrast, little is known about the extent of urinary symptoms in other movement disorders such as dystonia and about the role of the basal ganglia in bladder control.. PATIENTS AND METHODS: A consecutive series of 11 patients with severe dystonia undergoing deep brain stimulation (DBS) of the globus pallidus internus was prospectively enrolled. Bladder function was assessed by the International Prostate Symptom Score and urodynamic investigation (UDI) before DBS surgery and afterwards in the conditions with and without DBS. RESULTS: In UDI before DBS surgery, detrusor overactivity was found in 36% (4/11) of dystoniapatients. With pallidal DBS ON, maximum flow rate significantly decreased, post-void residual significantly increased and detrusor overactivity disappeared.. CONCLUSIONS: Pathological urodynamic changes can be found in a relevant percentage of dystoniapatients. Pallidal DBS has a relaxing effect on detrusor function indicating a role of the basal ganglia in lower urinary tract control. Thus, a better understanding on how subcortical networks influence lower urinary tract function might open new therapeutic perspectives..
Authors: Stephen Mock; David J Osborn; Elizabeth T Brown; W Stuart Reynolds; Maxim Turchan; Srivatsan Pallavaram; William Rodriguez; Roger Dmochowski; Christopher M Tolleson Journal: Neuromodulation Date: 2016-05-12