Ongoing clinical trial investigating the effects of transcranial magnetic stimulation (rTMS) on bladder function in individuals with multiple sclerosis.

Study Statement:

We are conducting a clinical trial investigating the effects of transcranial magnetic stimulation (rTMS) on bladder function in individuals with multiple sclerosis (MS). This study targets two key brain regions implicated in lower urinary tract control: the supplementary motor area (SMA) and the dorsolateral prefrontal cortex (DLPFC), using low-frequency stimulation for the SMA and high-frequency stimulation for the DLPFC. Outcome measures include validated questionnaires (IIQ-7, NBSS, AUASS, Overactive Bladder Awareness Tool), bladder diaries, uroflowmetry, urodynamics, and post-void residual volume. Functional MRI and diffusion tensor imaging (DTI) are performed at baseline and post-treatment to assess neuroplastic changes in brain activation and corticospinal tract integrity. Participants are followed at 1 and 3 months, with the option to join an open-label extension phase consisting of 10 additional rTMS sessions. Cognitive, mood, and quality-of-life assessments are also collected, including MoCA, HAM-A, HAM-D, HADS, C-SSRS, and Bain and Findley ADL scales, as well as session-level well-being ratings to explore the broader impact of rTMS on emotional and functional health.

Recruitment Blurb:

Living with MS or NMO and experiencing bladder symptoms? You may be eligible to join a clinical research study exploring a non-invasive brain stimulation technique to improve bladder control.

This study is designed for adult women (18+) diagnosed with multiple sclerosis (MS) or neuromyelitis optica (NMO) who have been experiencing bothersome bladder symptoms—such as urgency, frequency, incontinence, or nocturia—for at least 3 months. We are testing the effects of transcranial magnetic stimulation (rTMS), a safe, non-invasive procedure that targets specific areas of the brain involved in bladder control and emotional regulation.

You may be eligible if:

• You have a stable MS or NMO diagnosis (EDSS ≤ 7.5, no worsening in the last 6 months)
• You have neurogenic bladder symptoms (NBSS ≥ 15) and at least one storage symptom (e.g., urgency, frequency, nocturia), with an OAB Awareness Tool score ≥ 8
• You have a MoCA score > 10 (indicating sufficient cognitive function)
• Any active urinary tract infection is treated before enrollment

You may not be eligible if you:

• Are pregnant, nursing, or planning to become pregnant
• Have bladder outlet obstruction on urodynamics
• Use an intrathecal pump (e.g., baclofen), spinal cord stimulator, or pacemaker
• Have a history of seizures, a family history of epilepsy, or active substance use (e.g., heavy alcohol use)
• Have bipolar disorder or a psychotic disorder and are taking medications that may worsen these conditions (e.g., lithium, antipsychotics)
• Are currently on more than one antidepressant, or taking lithium for any condition
• Have had a hemorrhagic stroke or have intracranial lesions
• Have moderate to severe heart disease, unstable angina, or autonomic dysreflexia
• Have a history of interstitial cystitis, pelvic radiation, or recent bladder Botox injection (past 6 months)
• Use an indwelling catheter (urethral or suprapubic)
• Are currently incarcerated

All participants receive detailed assessments of bladder function, mood, and quality of life. The study includes baseline and follow-up visits, as well as optional access to active treatment for all participants during an open-label extension phase.

Interested in learning more or seeing if you qualify? Reach out today via the link below! We’d be happy to answer any questions and walk you through the next steps.

Clinical Trial Number (NCT06072703)

Prospective participant sign-up form