[Interest of transcranial stimulation in pelvic and perineal disorders]

Abstract

Objective: The aim of this article was to describe the diagnostic and therapeutic value of transcranial stimulation in pelvic and perineal disorders.

Methods: A literature review (Medline database and Google scholar) with no time limit was performed using keywords: "transcranial direct stimulation", "transcranial magnetic stimulation", "neurogenic bladder", "urinary incontinence", "Parkinson disease", "multiple sclerosis", "stroke", "muscle spasticity", "pelvic pain", "visceral pain".

Results: Twelve articles have been selected. Transcranial magnetic or electrical stimulation is a noninvasive neuromodulation technique widely used to establish brain maps to highlight causal relationships between brain and function. Regarding pelvic-perineal disorders, repeated transcranial stimulation has shown significant effects for the treatment of overactive bladder in Parkinson's disease (P<0.05) and multiple sclerosis, but also for the treatment of refractory chronic pelvic pain (P=0.026). Finally, therapeutic effects have also been demonstrated in irritable bowel syndrome. No evidence of efficacy was found on genito-sexual disorders.

Conclusion: Data from the literature suggest that transcranial stimulation is a noninvasive treatment that may have a role in the management of pelvic and perineal disorders. Its promising field of action would require prospective and randomized studies on a larger scale.

Keywords: Accident vasculaire cérébral; Douleur pelvienne; Douleur viscérale; Incontinence urinaire; Maladie de Parkinson; Multiple sclerosis; Muscle spasticity; Neurogenic bladder; Parkinson disease; Pelvic pain; Sclérose en plaques; Spasticité; Stimulation magnétique transcranienne; Stimulation électrique transcranienne directe; Stroke; Transcranial direct stimulation; Transcranial magnetic stimulation; Urinary incontinence; Vessie neurologique; Visceral pain.