Repetitive Transcranial Magnetic Stimulation for Chronic Prostatitis/Chronic Pelvic Pain Syndrome: A Prospective Pilot Study
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Purpose: To evaluate the feasibility, efficacy, and safety of repetitive transcranial magnetic stimulation (rTMS) in patients with treatment-resistant chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Methods: Eleven patients with CP/CPPS were enrolled in this prospective clinical study. rTMS was performed for 5 consecutive days in 20-minute sessions. Patients were evaluated at baseline, after treatment, and at 1, 4, 8, and 12 weeks after the last session with questionnaires concerning pain (numerical rating scale [NRS], the National Institutes of Health Chronic Prostatitis Symptom Index [NIH-CPSI], and the Short Form-36 [SF-36]), urinary symptoms (NIH-CPSI, Danish Prostatic Symptom Score [DAN-PSS-1]), quality of life (NIH-CPSI, SF-36), and psychometrics (Beck Depression Index [BDI]). Telephone-based interviews were used to evaluate side effects, subjective response, and changes in drug consumption. Results: All patients completed the planned treatment and follow-up according to protocol. No patients experienced serious side effects or significant pain increase during or after treatment. Mild transient tension headache responsive to oral pain medication was reported by 2 patients. Decreased pain was observed on the NRS after treatment and at 1 and 8 weeks (P=0.019, P=0.006, P=0.042, respectively) and on the NIH-CPSI pain domain at 1 week (P=0.04). Improvement in lower urinary tract symptoms was observed after treatment in the NIH-CPSI urinary domain (P=0.02) but not with the DANPSS-1. No significant changes in the BDI were observed. Nine patients reported a positive overall subjective response (82%) and 6 patients (55%) were able to reduce pain medication. Higher age was associated with lower NRS scores after treatment (R=0.605, P=0.048) and at 8 weeks (R=0.659, P=0.028). Conclusions: rTMS for patients with CP/CPPS seemed to be well tolerated, at least moderately effective in pain reduction, and might be of interest in patients with chronic pelvic pain resistant to conventional treatment. These findings remain to be confirmed by a randomized trial.
Abstract
Purpose: To evaluate the feasibility, efficacy, and safety of repetitive transcranial magnetic stimulation (rTMS) in patients with treatment-resistant chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Methods: Eleven patients with CP/CPPS were enrolled in this prospective clinical study. rTMS was performed for 5 consecutive days in 20-minute sessions. Patients were evaluated at baseline, after treatment, and at 1, 4, 8, and 12 weeks after the last session with questionnaires concerning pain (numerical rating scale [NRS], the National Institutes of Health Chronic Prostatitis Symptom Index [NIH-CPSI], and the Short Form-36 [SF-36]), urinary symptoms (NIH-CPSI, Danish Prostatic Symptom Score [DAN-PSS-1]), quality of life (NIH-CPSI, SF-36), and psychometrics (Beck Depression Index [BDI]). Telephone-based interviews were used to evaluate side effects, subjective response, and changes in drug consumption. Results: All patients completed the planned treatment and follow-up according to protocol. No patients experienced serious side effects or significant pain increase during or after treatment. Mild transient tension headache responsive to oral pain medication was reported by 2 patients. Decreased pain was observed on the NRS after treatment and at 1 and 8 weeks (P=0.019, P=0.006, P=0.042, respectively) and on the NIH-CPSI pain domain at 1 week (P=0.04). Improvement in lower urinary tract symptoms was observed after treatment in the NIH-CPSI urinary domain (P=0.02) but not with the DANPSS-1. No significant changes in the BDI were observed. Nine patients reported a positive overall subjective response (82%) and 6 patients (55%) were able to reduce pain medication. Higher age was associated with lower NRS scores after treatment (R=0.605, P=0.048) and at 8 weeks (R=0.659, P=0.028). Conclusions: rTMS for patients with CP/CPPS seemed to be well tolerated, at least moderately effective in pain reduction, and might be of interest in patients with chronic pelvic pain resistant to conventional treatment. These findings remain to be confirmed by a randomized trial.
참고문헌 (25)
- Mehik A, "Epidemiology of prostatitis in Finnish men : a population-based crosssectional study", BJU Int, 86, pp.443~448 (2000)
- Franco J, "Interventions for treating chronic prostatitis", chronic pelvic pain syndrome(Protocol), 2016, pp.2016, CD012320~
- Nickel JC, "Research guidelines for chronic prostatitis: consensus report from the first National Institutes of Health International Prostatitis Collaborative Network", Urology, 54, pp.229~233 (1999)
- Walz J, "Impact of chronic prostatitis-like symptoms on the quality of life in a large group of men", BJU Int, 100, pp.1307~1311 (2007)
- Pavone-Macaluso M, "Chronic prostatitis syndrome: a common, but poorly understood condition. Part I", EAU-EBU Update Series, 5, pp.1~15 (2007)
- 권종규, "Pain, Catastrophizing, and Depression in Chronic Prostatitis", Chronic Pelvic Pain Syndrome, 2013, pp.17(2), 48~58[DOI]
- Schaeffer AJ, "Epidemiology and demographics of prostatitis", Andrologia, 35, pp.252~257 (2003)
- Engeler DS, "The 2013 EAU guidelines on chronic pelvic pain: is management of chronic pelvic pain a habit, a philosophy, or a science? 10 years of development", Eur Urol, 64, pp.431~439 (2013)
- Nickel JC, "Failure of a monotherapy strategy for difficult chronic prostatitis", chronic pelvic pain syndrome, 2004, pp.172, 551~554
- Cruccu G, "EFNS guidelines on neurostimulation therapy for neuropathic pain", Eur J Neurol, 14, pp.952~970 (2007)
- Lefaucheur JP, "Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS)", Clin Neurophysiol, 125, pp.2150~2206 (2014)
- Lan L, "The efficacy of transcranial magnetic stimulation on migraine : a meta-analysis of randomized controlled trails", J Headache Pain, 18, pp.86~ (2017)
- Cervigni M, "Repetitive transcranial magnetic stimulation for chronic neuropathic pain in patients with bladder pain syndrome", interstitial cystitis, 2018, pp.37, 2678~2687
- Groppa S, "A practical guide to diagnostic transcranial magnetic stimulation : report of an IFCN committee", Clin Neurophysiol, 123, pp.858~882 (2012)
- Awiszus F, "TMS and threshold hunting", Suppl Clin Neurophysiol, 56, pp.13~23 (2003)
- Leskinen MJ, "The Finnish version of The National Institutes Of Health Chronic Prostatitis Symptom Index correlates well with the visual pain scale : translation and results of a modified linguistic validation study", BJU Int, 92, pp.251~256 (2003)
- Pontari MA, "Mechanisms in prostatitis", chronic pelvic pain syndrome, 2004, pp.172, 839~845
- Doiron RC, "Management of chronic prostatitis", chronic pelvic pain syndrome, 2018, pp.12(6 Suppl 3), S161~S163
- Hoogendam JM, "Physiology of repetitive transcranial magnetic stimulation of the human brain", Brain Stimul, 3, pp.95~118 (2010)
- Lefaucheur JP, "Cortical neurostimulation for neuropathic pain : state of the art and perspectives", Pain, 157(Suppl 1), pp.S81~S89 (2016)
- Lamusuo S, "Neurotransmitters behind pain relief with transcranial magnetic stimulation-positron emission tomography evidence for release of endogenous opioids", Eur J Pain, 21, pp.1505~1515 (2017)
- Pinot-Monange A, "Repetitive Transcranial Magnetic Stimulation Therapy(rTMS)for Endometriosis Patients with Refractory Pelvic Chronic Pain : A Pilot Study", J Clin Med, 8, pp.508~ (2019)
- Rossi S, "Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research", Clin Neurophysiol, 120, pp.2008~2039 (2009)
- Salaffi F, "Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale", Eur J Pain, 8, pp.283~291 (2004)
- Hamid P, "Noninvasive transcranial magnetic stimulation(TMS)in chronic refractory pain : a systematic review", Cureus, 11, pp.e6019~ (2019)