Tibial Nerve Intervention for Overactive Bladder

膀胱过动症（OAB）是老年人常见的疾病，常导致尿失禁（UI）。它会对总体生活质量产生重大影响，可能导致尿路感染。然而，过度活跃的膀胱仍然缺乏研究和污名化。项目目标：本项目的目的是开发一种神经假体装置，以帮助使用神经调节治疗OAB。为了实现这一广泛的目标，我们将研究通过胫骨神经驱动排尿反应调节的鲜为人知的神经回路。除了神经科学探索，该项目旨在测试该技术的剂量相关功效，从而优化干预措施。在此过程中，预测结果将有助于正在进行的关于人工智能驱动的尿路感染监测、预测和预防的多学科项目。新颖性：该项目在我们目前对膀胱调节的理解和OAB的治疗方法方面都是新颖的。首先，虽然胫骨神经刺激作为一种干预的效果是已知的，但神经回路的确切地形仍然是一个“黑盒子”。因此，本项目对具有显著治疗潜力的电路的功能提供了重要的见解。其次，目前针对OAB的干预措施本质上通常是药理学的，因此与一系列不良副作用相关，通常导致患者辍学率高。不幸的是，替代的非药物干预，如经皮胫神经刺激并不能完全解决这个问题。虽然有效，但这些技术仍然是侵入性的和不舒服的，需要训练有素的医疗专业人员来管理。因此，目前的项目提供了一种非侵入性、耐受性良好的干预方法的可能性，这种方法可以在对日常生活影响尽可能小的情况下使用，理论上可以鼓励患者保留。此外，假体装置的便携性使长期控制病情成为可能，这在目前是不可行的。最后，通过更深入地了解外周膀胱控制的机制基础，该项目可能为未来研究OAB干预的替代靶点奠定基础。方法方法：与利益相关者（如患者和临床医生）密切合作，我们将探索干预的疗效和机制。总结：总之，本项目将为临床相关的神经回路提供急需的见解，并有助于以患者为中心的干预措施的发展。

Overactive bladder (OAB) is a common medical condition among elderly individuals, often resulting in Urinary Incontinence (UI). It can have significant impacts on general quality of life, potentially leading to urinary tract infection. However, overactive bladder remains under-researched and stigmatised.Project Objectives: The aim of this project is to develop a neuroprosthetic device to aid the treatment of OAB using neuromodulation. To achieve this broad aim, we will study of the poorly understood neural circuitry that drive the modulation of the micturition response via the tibial nerve. In addition to this neuroscientific exploration, the project aims to test the dose-related efficacy of the technique, thereby optimising the intervention. In doing so, the predicted findings will contribute to an ongoing multidisciplinary project concerning the AI-driven monitoring, prediction, and prevention of urinary tract infection.Novelty: The project is novel in both its approach to our current understanding of bladder modulation, and the treatment of OAB. Firstly, while the efficacy of tibial nerve stimulation as an intervention is known, the exact topography of the neural circuit remains a "black-box". Consequently, the present project provides vital insight into the function of a circuit with significant therapeutic potential.Secondly, present interventions for OAB are typically pharmacological in nature, and as such are associated with a range of undesirable side-effects often resulting in high rates of patient drop-off. Unfortunately, alternate non-pharmacological interventions such as percutaneous tibial nerve stimulation do not entirely solve this issue. While effective, these techniques remain invasive and uncomfortable, requiring a trained medical professional for administration. Therefore, the present project provides the possibility of a non-invasive, well-tolerated intervention that may be used with as little impact on daily life as possible, in theory encouraging patient retention.In addition, the portability of the prosthetic device enables longer-term control of the condition, which is not presently feasible. Finally, through providing a greater understanding of the mechanistic underpinnings of peripheral bladder control, the project may lay the groundwork for future research concerning alternative targets for OAB intervention.Methodological Approach: Working closely with stakeholders, (e.g., patients and clinicians), we will explore the efficacy and mechanism of the intervention. Summary: In conclusion, the present project will provide much-needed insight into a clinically relevant neural circuit and aid the development of a patient-centred intervention.