A prospective feasibility study to differentiate sacral neuromodulation lead electrode configurations using motor and sensory thresholds and locations of sensation

Abstract Background Accurate positioning and programming of sacral neuromodulation (SNM) relies upon the use of several intraoperative and postoperative stimulation measurements. While the clinical utility of these acute measurements including pelvic floor motor thresholds (PFMT), toe/leg motor thre...

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Main Authors: Tianyu He, Christopher Hornung, Michael D. Evans, Stephanie J. Zoghbi, Leya A. Chahine, Fatima A. Nazar, Dwight E. Nelson, Nissrine Nakib
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Urology
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Online Access:https://doi.org/10.1186/s12894-025-01724-8
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author Tianyu He
Christopher Hornung
Michael D. Evans
Stephanie J. Zoghbi
Leya A. Chahine
Fatima A. Nazar
Dwight E. Nelson
Nissrine Nakib
author_facet Tianyu He
Christopher Hornung
Michael D. Evans
Stephanie J. Zoghbi
Leya A. Chahine
Fatima A. Nazar
Dwight E. Nelson
Nissrine Nakib
author_sort Tianyu He
collection DOAJ
description Abstract Background Accurate positioning and programming of sacral neuromodulation (SNM) relies upon the use of several intraoperative and postoperative stimulation measurements. While the clinical utility of these acute measurements including pelvic floor motor thresholds (PFMT), toe/leg motor thresholds (TMT), and sensory thresholds (ST), are widely accepted, their usefulness in quantitative research remains unclear. The purpose of this prospective study was to test these measurements and gauge their utility in future research. Methods Eight participants received Axonics SNM, 6 Medtronic Interstim II, and 2 Medtronic Micro SNM. PFMT was measured after implantation. ST and the location of sensation (LOS) were measured immediately postoperatively (PO), at pre-release from the surgery center (PR), and during a follow-up clinic visit (FU). Thresholds were compared across contact and time using linear mixed-effects models. Results Significant differences in PFMT were found across electrode configurations, with stimulation through proximal contacts exhibiting lower PFMT than distal configurations. ST displayed no significant differences across electrodes and showed minimal changes over time. LOS exhibited substantial variability across patients and periods. Conclusions Results suggest that PFMT were able to differentiate differences across electrode configurations that may be useful for future quantitative research. The lack of differences in ST and LOS across electrode configurations was interesting given the focus on these measurements clinically. Future testing is to confirm these limitations.
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spelling doaj-art-a79ec4f53b154702a8fd76454885e9bd2025-08-20T02:11:42ZengBMCBMC Urology1471-24902025-04-012511810.1186/s12894-025-01724-8A prospective feasibility study to differentiate sacral neuromodulation lead electrode configurations using motor and sensory thresholds and locations of sensationTianyu He0Christopher Hornung1Michael D. Evans2Stephanie J. Zoghbi3Leya A. Chahine4Fatima A. Nazar5Dwight E. Nelson6Nissrine Nakib7Department of Urology, University of MinnesotaDepartment of Urology, University of MinnesotaClinical and Translational Science Institute, University of MinnesotaMedical Research Volunteer Program, American University of BeirutMedical Research Volunteer Program, American University of BeirutMedical Research Volunteer Program, American University of BeirutDepartment of Urology, University of MinnesotaDepartment of Urology, University of MinnesotaAbstract Background Accurate positioning and programming of sacral neuromodulation (SNM) relies upon the use of several intraoperative and postoperative stimulation measurements. While the clinical utility of these acute measurements including pelvic floor motor thresholds (PFMT), toe/leg motor thresholds (TMT), and sensory thresholds (ST), are widely accepted, their usefulness in quantitative research remains unclear. The purpose of this prospective study was to test these measurements and gauge their utility in future research. Methods Eight participants received Axonics SNM, 6 Medtronic Interstim II, and 2 Medtronic Micro SNM. PFMT was measured after implantation. ST and the location of sensation (LOS) were measured immediately postoperatively (PO), at pre-release from the surgery center (PR), and during a follow-up clinic visit (FU). Thresholds were compared across contact and time using linear mixed-effects models. Results Significant differences in PFMT were found across electrode configurations, with stimulation through proximal contacts exhibiting lower PFMT than distal configurations. ST displayed no significant differences across electrodes and showed minimal changes over time. LOS exhibited substantial variability across patients and periods. Conclusions Results suggest that PFMT were able to differentiate differences across electrode configurations that may be useful for future quantitative research. The lack of differences in ST and LOS across electrode configurations was interesting given the focus on these measurements clinically. Future testing is to confirm these limitations.https://doi.org/10.1186/s12894-025-01724-8NeurostimulationOveractive bladderSacral neuromodulationMotor thresholdSensory threshold
spellingShingle Tianyu He
Christopher Hornung
Michael D. Evans
Stephanie J. Zoghbi
Leya A. Chahine
Fatima A. Nazar
Dwight E. Nelson
Nissrine Nakib
A prospective feasibility study to differentiate sacral neuromodulation lead electrode configurations using motor and sensory thresholds and locations of sensation
BMC Urology
Neurostimulation
Overactive bladder
Sacral neuromodulation
Motor threshold
Sensory threshold
title A prospective feasibility study to differentiate sacral neuromodulation lead electrode configurations using motor and sensory thresholds and locations of sensation
title_full A prospective feasibility study to differentiate sacral neuromodulation lead electrode configurations using motor and sensory thresholds and locations of sensation
title_fullStr A prospective feasibility study to differentiate sacral neuromodulation lead electrode configurations using motor and sensory thresholds and locations of sensation
title_full_unstemmed A prospective feasibility study to differentiate sacral neuromodulation lead electrode configurations using motor and sensory thresholds and locations of sensation
title_short A prospective feasibility study to differentiate sacral neuromodulation lead electrode configurations using motor and sensory thresholds and locations of sensation
title_sort prospective feasibility study to differentiate sacral neuromodulation lead electrode configurations using motor and sensory thresholds and locations of sensation
topic Neurostimulation
Overactive bladder
Sacral neuromodulation
Motor threshold
Sensory threshold
url https://doi.org/10.1186/s12894-025-01724-8
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