AUTHOR=Nizard Julien , Esnault Julien , Bouche Bénédicte , Suarez Moreno Alcira , Lefaucheur Jean-Pascal , Nguyen Jean-Paul 

TITLE=Long-Term Relief of Painful Bladder Syndrome by High-Intensity, Low-Frequency Repetitive Transcranial Magnetic Stimulation of the Right and Left Dorsolateral Prefrontal Cortices

JOURNAL=Frontiers in Neuroscience

VOLUME=12

YEAR=2018

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2018.00925

DOI=10.3389/fnins.2018.00925

ISSN=1662-453X

ABSTRACT=<p><bold>Aim:</bold> To show the value of low-frequency repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex (DLPFC) to treat bladder pain syndrome (BPS), characterized by suprapubic pain, urgency and increased micturition frequency.</p><p><bold>Methods:</bold> A 68-year-old woman with BPS underwent 16 sessions of high-intensity, low-frequency (1 Hz) rTMS of the DLPFC, first on the right hemisphere (one daily session for 5 days, followed by one weekly session for 5 weeks), and then on the left hemisphere (one monthly session for 6 months).</p><p><bold>Results:</bold> At the end of the rTMS protocol, suprapubic pain completely vanished, micturition frequency dramatically decreased (by 60–80%), while fatigue and sleep quality improved (by 57–60%). The patient reported an overall satisfaction rate of 80% and her activities of daily living tending to normalize.</p><p><bold>Conclusion:</bold> This is the first report showing that high-intensity, low-frequency rTMS delivered on the DLPFC region of both hemispheres can relieve most symptoms of BPS (pain, urinary symptoms, and interference with physical functioning) in clinical practice.</p>