- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04652869
Mindfulness + tDCS to Reduce Urgency Incontinence in Women
February 15, 2023 updated by: Cynthia Conklin
Urge urinary incontinence (UUI) is a common problem in older women, which vastly reduces quality of life.
UUI sufferers frequently report situational triggers (e.g.
approaching the front door) leading to urinary urgency and/or leakage, which can be caused by psychological conditioning.
This project will test the feasibility, acceptability, and efficacy of brief mindfulness (MI) and non-invasive brain stimulation (transcranial direct current stimulation; tDCS) to reduce reactivity to personal urgency cues and attenuate symptoms of UUI.
This is a novel step towards providing personalized efficacious non-pharmacologic treatment for UUI.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Urinary urgency incontinence (UUI) is a highly prevalent, morbid and costly (up to $83 billion/year) disorder among older women, with up to 36% of those over 65 afflicted.
One commonly experienced phenomenon among those with UUI is conditioned bladder responses to external triggers, often labeled "situational incontinence."
Situational incontinence is described by sufferers as urinary urgency and leakage when confronted with specific contextual triggers or cues, such as approaching the front/garage door 'latch-key incontinence', and exposure to running water such as doing dishes.
Generally ascribed to 'bladder spasms' (detrusor overactivity), studies have revealed that anywhere between 42% and 80% of women with UUI experience situationally provoked urgency, with approximately 26% of those experiencing situationally triggered leakage.
The researchers recent work has focused on developing methods to recreate exposure to individuals' situational urgency cues, testing the impact of "urgency" and "safe" cues on self-report urgency and actual leakage, and finally assessing the role of bladder control mechanisms in the brain in response to these personal situational cues.
The researchers found that women with situational UUI experienced increased urgency and leakage when exposed to personal "urgency" versus "safe" photographic cues from their daily lives.
Further, brain areas related to attentional and visuospatial processing were activated during exposure to urge, but not safe, cues.
Past studies of urgency simulated by bladder filling, show that prefrontal cortex, a seat of executive control, is activated to aid in controlling bladder activation.
However, the study found that the PFC was not recruited during exposure to visual cues among women with situational urgency.
Thus, the researchers propose that interventions capable of enhancing PFC activation during exposure to urgency situations should enable women to gain executive control over cues and result in less cue-provoked urgency and leakage, as well as overall UUI symptomatology.
Using these now well-tested methods to personalize stimuli with photographs of urgency-provoking situational cues, the goal is to test the feasibility, acceptability, and compliance of these promising methods to attenuate urgency-related reactivity and reduce UUI symptoms.
These novel methods include: (1) Brief mindfulness (MI) focused on body scan and acceptance language, (2) Transcranial direct current stimulation (tDCS) applied to the dorsolateral PFC, and (3) a combination of MI + tDCS.
Sixty women with situational UUI will be randomized into a 7-session study, with a mail-in follow up 1-week post-training.
All participants will undergo 4 urgency-cue exposure training sessions during which they will engage in one of the three interventions, based on group.
Changes in urgency will be assessed via pre-post training differences in: Cue-reactivity to personal urge and safe cues, reaction time to a urinary Stroop task, self-report severity of bladder problems, and UUI episodes and urgency ratings on a daily bladder diary.
Attenuating reactivity to situational urgency cues will increase our ability to complement and enhance the efficacy of UUI therapy and reduce symptom burden for its many sufferers.
Study Type
Interventional
Enrollment (Actual)
121
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Pennsylvania
-
Pittsburgh, Pennsylvania, United States, 15213
- University of Pittsburgh
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
40 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
Female
Description
Inclusion Criteria:
- Female; 40+ years old
- Self-report situational urgency in at least 4 of 15 common scenarios
- At least 2 leaks/week
- Urge Urinary Incontinence symptomatology bother score ≥4
Exclusion Criteria:
- Cognitive impairment (inability to complete tasks) as measured by an MoCA < 26
- Urinary retention (PVR>200ml)
- Interstitial cystitis
- Spinal cord injury
- Pelvic irradiation or other cause of pelvic nerve damage
- Active urinary tract infection (UTI)
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Mindfulness Training
Mindfulness training
|
Mindfulness is a type of meditation in which you focus on being intensely aware of what you're sensing and feeling in the moment, without interpretation or judgment.
|
Experimental: Transcranial Direct Current Stimulation (tDCS)
Transcranial direct current stimulation targeting the dorsolateral prefrontal cortex
|
Transcranial direct current stimulation targeting the dorsolateral prefrontal cortex
Other Names:
|
Experimental: Mindfulness + tDCS
Mindfulness training with transcranial direct current stimulation targeting the dorsolateral prefrontal cortex
|
Mindfulness is a type of meditation in which you focus on being intensely aware of what you're sensing and feeling in the moment, without interpretation or judgment.
Transcranial direct current stimulation targeting the dorsolateral prefrontal cortex
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Feasibility of study procedures measured by percentage of enrolled participants who complete the study
Time Frame: 4-weeks
|
4-weeks
|
|
Acceptability of study procedures measured by 8-item with a 0-100 scale on the Post-Study Survey. A higher score indicates greater acceptability.
Time Frame: 4-weeks
|
4-weeks
|
|
Compliance with study procedures measured by 2-items with a 0-100 scale on the Post-Study Survey. A higher score indicates greater compliance
Time Frame: 4-weeks
|
4-weeks
|
|
Change from baseline in cue-induced reactivity to personal photographic urge cues as measured by a 8-item 0-100 scale questionnaire. A higher score indicates greater cue-reactivity
Time Frame: Baseline to 1 week
|
Baseline to 1 week
|
|
Reaction time to Urinary Stroop Task
Time Frame: Baseline to 1 week
|
Change in reaction time to words associated with urgency
|
Baseline to 1 week
|
Change from baseline in severity of bladder problem measured by the ICIQ-FLUTS a 12-item questionnaire evaluating urinary tract symptoms and impact on quality of life. A higher score indicates greater symptoms and greater impact on quality of life.
Time Frame: Baseline to 1 week
|
Baseline to 1 week
|
|
Urge Urinary Incontinence (UUI) Incidence
Time Frame: Baseline to 1 week
|
Change in the number of UUI Incidences
|
Baseline to 1 week
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Treatment Change
Time Frame: 4 weeks
|
Treatment change will be examined by plotting the slope and linearity of daily bladder diary and urgency survey data
|
4 weeks
|
Individual Differences as measured by age, years of UUI and baseline measures as moderators of the efficacy of the intervention
Time Frame: 4 weeks
|
4 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
May 21, 2021
Primary Completion (Actual)
February 3, 2023
Study Completion (Actual)
February 10, 2023
Study Registration Dates
First Submitted
November 25, 2020
First Submitted That Met QC Criteria
December 2, 2020
First Posted (Actual)
December 3, 2020
Study Record Updates
Last Update Posted (Estimate)
February 16, 2023
Last Update Submitted That Met QC Criteria
February 15, 2023
Last Verified
February 1, 2023
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- STUDY19110132
- 1R21AG064361 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
YES
IPD Plan Description
All of the individual participant data collected during the trial, after de-identification may be shared with other researchers.
IPD Sharing Time Frame
Following publication, no end date
IPD Sharing Access Criteria
Any purpose
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
Yes
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Urinary Incontinence, Urge
-
TriHealth Inc.TerminatedUrinary Urge IncontinenceUnited States
-
Duke UniversitySociety of Urodynamics and Female Pelvic Medicine & Urogenital ReconstructionTerminatedUrinary Urge IncontinenceUnited States
-
Juna d.o.o.CompletedFemale Stress Urinary Incontinence | Mixed Incontinence, Urge and Stress
-
Elidah, Inc.RecruitingUrge IncontinenceUnited States
-
University of New MexicoRecruitingUrinary Incontinence | Urge Incontinence | Stress Incontinence, FemaleUnited States
-
Klinikum der Universität KölnUnknownSurgical Treatment of Urge IncontinenceGermany
-
Valencia Technologies CorporationCompletedOveractive Bladder | Urge Incontinence | Urinary Urge Incontinence | Incontinence, UrinaryUnited States, New Zealand
-
Prof. Dr. Volker ViereckCompletedMixed Incontinence, Urge and StressSwitzerland
-
Stamford HospitalWithdrawnOveractive Bladder | Urge Incontinence | Urinary UrgeUnited States
-
Kasr El Aini HospitalUnknownFemales With Overactive Bladder Symptoms, Urgency & Urge Incontinence
Clinical Trials on Mindfulness
-
University of Illinois at Urbana-ChampaignNorthwestern University Feinberg School of Medicine; Southern Illinois University and other collaboratorsNot yet recruitingPain, Postoperative | Depression, Unipolar
-
University of HoustonCompletedDepression | Stress | Anxiety | Well-beingUnited States
-
University of HawaiiVA Palo Alto Health Care SystemCompletedCancer, Other Than Non-melanoma Skin CancerUnited States
-
Monash University MalaysiaCompleted
-
Oregon Health and Science UniversityPortland VA Medical CenterCompleted
-
Lund UniversityCompleted
-
University of UlsterRecruitingCervical Cancer | Gynecologic Cancer | Vulvar Cancer | Vaginal Cancer | Uterus Cancer | Ovary CancerUnited Kingdom
-
Sam Houston State UniversityTerminated