Objective: To undertake a randomised control trial of transcutaneous tibial nerve stimulation (TTNS) delivered by Geko™ device for LUTS related to overactive bladder (OAB) symptoms in PD.

Background: Lower urinary tract symptoms (LUTS) are common in Parkinson’s disease and are associated with poorer quality of life, higher morbidity and even mortality. Existing treatments are often unhelpful and/or limited by side-effects. One potential non-pharmacological treatment for LUTS in PD is peripheral neuromodulation, however, past research has often been limited by small sample size and the absence of a control group.

Method: Participants were required to have idiopathic PD and clinical OAB. Participants were randomised to active TTNS or sham stimulation (alternate side to tibial nerve, lowest setting), administered for 30 minutes, twice-weekly over 12 weeks. Primary outcome measure was the ICIQ-OAB questionnaire score at 12 weeks. Secondary outcomes included global rating of change and bladder diary outcomes.

Results: 148 participants were enrolled (73 active, 75 sham). No significant difference was seen for the ICIQ-OAB scores between arms at 12 weeks (coefficient 0.48; 95% CI -0.2, 1.2; P=0.17). Both active and sham arms found improvements, above minimal clinically important difference, between baseline and 12 weeks follow-up (active: -1.2 points; 95% CI -1.7, -0.6, P=0.001 and sham: -1.7 points; 95% CI -2.2, -1.3; P<0.001).

Conclusion: We found no difference between active and sham arms at 12 weeks, though both groups’ LUTS improved over time, suggesting a placebo effect. We cannot totally exclude the possibility that the sham intervention had a biological effect.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/transcutaneous-tibial-nerve-stimulation-for-overactive-bladder-symptoms-in-parkinsons-disease-results-from-a-phase-ii-randomised-control-trial-stripe/