{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T06:18:54Z","timestamp":1787897934767,"version":"build-2784847793"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Hum. Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to explore brain activity and functional connectivity changes associated with transcutaneous tibial nerve stimulation (TTNS) in patients with neurogenic overactive bladder (OAB), alongside changes in clinical symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective longitudinal self-controlled trial, conducted at the China Rehabilitation Research Center from 2024 to 2025, enrolled 15 adults with symptom-defined neurogenic OAB associated with spinal cord injury or multiple sclerosis. Resting-state functional magnetic resonance imaging (fMRI) was performed before and after standardized TTNS under full- and empty-bladder conditions. The primary imaging outcomes were fractional amplitude of low-frequency fluctuations (fALFF) and functional connectivity (FC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      TTNS significantly enhanced clinical outcomes, reducing 24\u202fh urinary frequency from 15.53\u202f\u00b1\u202f2.97 to 12.87\u202f\u00b1\u202f2.88 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and decreasing OABSS from 9.67\u202f\u00b1\u202f1.50 to 8.53\u202f\u00b1\u202f1.41 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Neuroimaging indicated improvements were supported by notable increases in neural activity during bladder fullness, particularly in the fALFF of the left cerebellum posterior lobe (\n                      <jats:italic>p<\/jats:italic>\n                      FWE\u202f&amp;lt;\u202f0.001) and right medial frontal gyrus (\n                      <jats:italic>p<\/jats:italic>\n                      FWE\n                      <jats:italic>=<\/jats:italic>\n                      0.004). Additionally, FC between the left cerebellum posterior lobe and left fusiform gyrus was strengthened (\n                      <jats:italic>p<\/jats:italic>\n                      FWE\n                      <jats:italic>=<\/jats:italic>\n                      0.005). Correlation analysis revealed that higher functional connectivity was associated with lower OAB symptom scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001). Importantly, Baseline fALFF differences between bladder states no longer met the corrected significance threshold after treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this cohort, 1\u202fmonth of TTNS was associated with reductions in urinary frequency and OABSS and with changes in fALFF and FC. These preliminary findings do not establish neuroplasticity, normalization, or a causal TTNS-specific mechanism and require confirmation in adequately powered sham-controlled studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.chictr.org.cn\/hvshowprojectEN.html?id=300046&amp;amp;v=1.0<\/jats:ext-link>\n                      , Identifier: ChiCTR2600122960\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnhum.2026.1849595","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:35:45Z","timestamp":1787895345000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of transcutaneous tibial nerve stimulation on brain function in patients with overactive bladder: a prospective longitudinal self-controlled study"],"prefix":"10.3389","volume":"20","author":[{"given":"Ziyu","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Urology, Rehabilitation School of Capital Medical University, China Rehabilitation Research Center","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuansong","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Urology, General Hospital of Southern Theater Command","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangjun","family":"Lyu","sequence":"additional","affiliation":[{"name":"Department of Urology, The Third Medical Center of Chinese PLA General Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Urology, Rehabilitation School of Capital Medical University, China Rehabilitation Research Center","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, Rehabilitation School of Capital Medical University, China Rehabilitation Research Center","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongsheng","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linquan","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Urology, Rehabilitation School of Capital Medical University, China Rehabilitation Research Center","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Urology, Rehabilitation School of Capital Medical University, China Rehabilitation Research Center","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2700227","DOI":"10.1155\/2022\/2700227","article-title":"Posterior tibial nerve stimulation for overactive bladder: mechanism, classification, and management outlines","volume":"2022","author":"Al-Danakh","year":"2022","journal-title":"Parkinsons Dis."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"5667","DOI":"10.1523\/jneurosci.2924-19.2021","article-title":"Neural substrates of muscle co-contraction during dynamic motor adaptation","volume":"41","author":"Babadi","year":"2021","journal-title":"J. Neurosci."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"492","DOI":"10.4081\/aiua.2022.4.492","article-title":"Efficacy of overactive neurogenic bladder treatment: a systematic review of randomized controlled trials","volume":"94","author":"Bapir","year":"2022","journal-title":"Archiv. Ital. Urol. Androl."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s40673-020-00119-9","article-title":"Cerebellum and micturition: what do we know? A systematic review","volume":"7","author":"Bastide","year":"2020","journal-title":"Cerebellum. Ataxias"},{"key":"ref5","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-030-99550-8_3","volume-title":"Cerebellum and Emotion Processing","author":"Baumann","year":"2022"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1695","DOI":"10.1177\/02841851211057278","article-title":"Abnormal resting-state brain activity and connectivity of brain-bladder control network in overactive bladder syndrome","volume":"63","author":"Biao","year":"2021","journal-title":"Acta Radiol."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1080\/17434440.2023.2254678","article-title":"Device evaluation: eCoin #x2013; implantable tibial nerve stimulator for overactive bladder","volume":"20","author":"Bressington","year":"2023","journal-title":"Expert Rev. Med. 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J."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"120108","DOI":"10.1016\/j.neuroimage.2023.120108","article-title":"Structural and functional connectivity reconstruction with CATO\u2014a Connectivity Analysis TOolbox","volume":"273","author":"de Lange","year":"2023","journal-title":"NeuroImage"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1007\/s10548-025-01133-y","article-title":"Exploring facial nucleus-centered connectivity in hemifacial spasm: novel insights into pathogenesis and surgical impact","volume":"38","author":"Duan","year":"2025","journal-title":"Brain Topogr."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/1471-2296-15-96","article-title":"The patient perspective on overactive bladder: a mixed-methods needs assessment","volume":"15","author":"Filipetto","year":"2014","journal-title":"BMC Fam. Pract."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1805","DOI":"10.1007\/s11255-021-02880-0","article-title":"Regional activity and functional connectivity in brain networks associated with urinary bladder filling in patients with tethered cord syndrome","volume":"53","author":"Gao","year":"2021","journal-title":"Int. Urol. Nephrol."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1186\/1471-2490-13-61","article-title":"Percutaneous tibial nerve stimulation (PTNS) efficacy in the treatment of lower urinary tract dysfunctions: a systematic review","volume":"13","author":"Gaziev","year":"2013","journal-title":"BMC Urol."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"337","DOI":"10.5213\/inj.2040408.204","article-title":"Randomized crossover-controlled evaluation of simultaneous bilateral transcutaneous electrostimulation of the posterior tibial nerve during urodynamic studies in patients with lower urinary tract symptoms","volume":"25","author":"Girtner","year":"2021","journal-title":"Int. Neurourol. J."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1016\/j.urology.2011.06.020","article-title":"Responsiveness and minimal clinically important change in overactive bladder symptom score","volume":"78","author":"Gotoh","year":"2011","journal-title":"Urology"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1111\/j.1464-410X.2008.08036.x","article-title":"The economic impact of overactive bladder syndrome in six western countries","volume":"103","author":"Irwin","year":"2009","journal-title":"BJU Int."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2135","DOI":"10.1109\/tnsre.2025.3575009","article-title":"Benchmarking TENSmini for neuromodulation via tibial nerve stimulation","volume":"33","author":"Ju","year":"2025","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"2830","DOI":"10.1002\/hbm.23543","article-title":"Tuning face perception with electrical stimulation of the fusiform gyrus","volume":"38","author":"Keller","year":"2017","journal-title":"Hum. Brain Mapp."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"2198","DOI":"10.1002\/nau.24473","article-title":"The effect of stroke on micturition associated brain activity: a pilot fMRI study","volume":"39","author":"Kreydin","year":"2020","journal-title":"Neurourol. Urodyn."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.1002\/nau.25197","article-title":"Differences between brain responses to peroneal electrical transcutaneous neuromodulation and transcutaneous tibial nerve stimulation, two treatments for overactive bladder","volume":"42","author":"Krhut","year":"2023","journal-title":"Neurourol. Urodyn."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1115433","DOI":"10.3389\/fnins.2023.1115433","article-title":"Real-time changes in brain activity during tibial nerve stimulation for overactive bladder: evidence from functional near-infrared spectroscopy hype scanning","volume":"17","author":"Li","year":"2023","journal-title":"Front. Neurosci."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.joim.2024.11.006","article-title":"Acupuncture at Weizhong (BL40) attenuates acetic acid-induced overactive bladder in rats by regulating brain neural activity through the modulation of mast cells and tibial nerves","volume":"23","author":"Liu","year":"2025","journal-title":"J. Integr. Med."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"e81121","DOI":"10.7759\/cureus.81121","article-title":"A prospective study on the effectiveness of sensory and sub-sensory stimulation amplitudes using eCoin\u00ae implantable tibial nerve stimulation in reducing urgency urinary incontinence episodes and enhancing quality of life","volume":"17","author":"Lucente","year":"2025","journal-title":"Cureus."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1436172","DOI":"10.3389\/fnins.2025.1436172","article-title":"Real-time changes in brain activity during sacral neuromodulation for overactive bladder: evidence from functional near-infrared spectroscopy","volume":"19","author":"Luo","year":"2025","journal-title":"Front. Neurosci."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"R366","DOI":"10.1152\/ajpregu.00490.2015","article-title":"Pudendal but not tibial nerve stimulation inhibits bladder contractions induced by stimulation of pontine micturition center in cats","volume":"310","author":"Lyon","year":"2015","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"2147","DOI":"10.1002\/nau.25535","article-title":"Cerebellar functional connectivity relates to lower urinary tract function: a 7 tesla study","volume":"43","author":"Mazeaud","year":"2024","journal-title":"Neurourol. Urodyn."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1016\/j.neurom.2025.01.013","article-title":"A first-in-human feasibility study of a new implantable tibial nerve stimulator for overactive bladder syndrome","volume":"28","author":"Sethi","year":"2025","journal-title":"Neuromodul. J. Internat. Neuromodul. Soc."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1097\/SPV.0000000000001616","article-title":"Transcutaneous tibial nerve stimulation for urge incontinence: a randomized clinical trial","volume":"31","author":"Shah","year":"2025","journal-title":"Urogynecol."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"27","DOI":"10.2147\/tcrm.s269318","article-title":"Assessing quality-of-life of patients taking mirabegron for overactive bladder","volume":"19","author":"Shaw","year":"2023","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1869","DOI":"10.12688\/f1000research.16418.1","article-title":"Understanding overactive bladder and urgency incontinence: what does the brain have to do with it?","volume":"7","author":"Smith","year":"2018","journal-title":"F1000Res"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"116676","DOI":"10.1016\/j.jns.2020.116676","article-title":"Urodynamic and gait analyses in multiple system atrophy","volume":"411","author":"Tsuchiya","year":"2020","journal-title":"J. Neurol. Sci."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1007\/s00192-024-06029-2","article-title":"Global prevalence of overactive bladder: a systematic review and meta-analysis","volume":"36","author":"Zhang","year":"2025","journal-title":"Int. Urogynecol. J."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"726505","DOI":"10.3389\/fnins.2021.726505","article-title":"Regulatory effects of acupuncture on emotional disorders in patients with menstrual migraine without aura: a resting-state fMRI study","volume":"15","author":"Zhang","year":"2021","journal-title":"Front. 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