Mindfulness and Transcranial Direct Current Stimulation (tDCS) to Attenuate Situational Urgency Urinary Incontinence (UUI): A randomized pilot study

Introduction:: Situational urgency urinary incontinence (UUI), triggered by situations such as approaching the front door and running water, accounts for up to half of all UUI episodes in women. We proposed a behavioral therapy to examine the independent and combined efficacy of mindfulness (MI) and...

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Main Authors: Cynthia A. Conklin, Brian Coffman, Carol M. Greco, Shachi Tyagi, Becky D. Clarkson
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Continence
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772973725000220
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author Cynthia A. Conklin
Brian Coffman
Carol M. Greco
Shachi Tyagi
Becky D. Clarkson
author_facet Cynthia A. Conklin
Brian Coffman
Carol M. Greco
Shachi Tyagi
Becky D. Clarkson
author_sort Cynthia A. Conklin
collection DOAJ
description Introduction:: Situational urgency urinary incontinence (UUI), triggered by situations such as approaching the front door and running water, accounts for up to half of all UUI episodes in women. We proposed a behavioral therapy to examine the independent and combined efficacy of mindfulness (MI) and transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex to attenuate reactivity to these scenarios and reduce UUI symptomatology. Methods:: Women aged over 40 reporting regular situationally triggered UUI, with at least two leaks per week, completed a 5-session study with 1-week follow-up. Participants created personal urgency and safe (non-urgency) photographic cues and were randomized to either: MI (n=20), tDCS (n = 18), or MI+tDCS (n = 20) interventions conducted during exposure to personal urgency images over 4 sessions. Pre-post assessments of UUI via bladder diary and questionnaire, reactivity to urgency cues, and attentional bias on a UUI-focused modified Stroop task were collected. Results:: Reactivity to personal cues was significantly reduced in all groups and attentional bias to toileting words was reduced in the MI+tDCS group. Number of leaks decreased in all groups between 0.81 (0.23) and 0.95 (0.23) episodes per day (p < 0.01). Daily urgency decreased significantly in the MI+tDCS group by 1.76 (0.47) episodes (p < 0.01). ICIQ-FLUTS score reduction was clinically meaningful at 1-week follow-up. The interventions demonstrated high feasibility and high rates of acceptability (>80/100) with participant compliance over 90% across groups. Conclusion:: Mindfulness and tDCS offer promising non-invasive therapeutic benefit for reducing UUI symptoms in women with potential for easy dissemination and high adherence without additional pharmaceutical burden.
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spelling doaj-art-211ae067b9944c34bc484f336a80be0a2025-08-20T02:37:03ZengElsevierContinence2772-97372025-06-011410176510.1016/j.cont.2025.101765Mindfulness and Transcranial Direct Current Stimulation (tDCS) to Attenuate Situational Urgency Urinary Incontinence (UUI): A randomized pilot studyCynthia A. Conklin0Brian Coffman1Carol M. Greco2Shachi Tyagi3Becky D. Clarkson4Department of Psychiatry, University of Pittsburgh, Thomas Detre Hall, 3811 O’Hara Street, Pittsburgh, PA 15213, USADepartment of Psychiatry, University of Pittsburgh, Thomas Detre Hall, 3811 O’Hara Street, Pittsburgh, PA 15213, USADepartment of Psychiatry, University of Pittsburgh, Thomas Detre Hall, 3811 O’Hara Street, Pittsburgh, PA 15213, USADivision of Geriatric Medicine, University of Pittsburgh Suite 500, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USADivision of Geriatric Medicine, University of Pittsburgh Suite 500, 3459 Fifth Avenue, Pittsburgh, PA, 15213, USA; Corresponding author.Introduction:: Situational urgency urinary incontinence (UUI), triggered by situations such as approaching the front door and running water, accounts for up to half of all UUI episodes in women. We proposed a behavioral therapy to examine the independent and combined efficacy of mindfulness (MI) and transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex to attenuate reactivity to these scenarios and reduce UUI symptomatology. Methods:: Women aged over 40 reporting regular situationally triggered UUI, with at least two leaks per week, completed a 5-session study with 1-week follow-up. Participants created personal urgency and safe (non-urgency) photographic cues and were randomized to either: MI (n=20), tDCS (n = 18), or MI+tDCS (n = 20) interventions conducted during exposure to personal urgency images over 4 sessions. Pre-post assessments of UUI via bladder diary and questionnaire, reactivity to urgency cues, and attentional bias on a UUI-focused modified Stroop task were collected. Results:: Reactivity to personal cues was significantly reduced in all groups and attentional bias to toileting words was reduced in the MI+tDCS group. Number of leaks decreased in all groups between 0.81 (0.23) and 0.95 (0.23) episodes per day (p < 0.01). Daily urgency decreased significantly in the MI+tDCS group by 1.76 (0.47) episodes (p < 0.01). ICIQ-FLUTS score reduction was clinically meaningful at 1-week follow-up. The interventions demonstrated high feasibility and high rates of acceptability (>80/100) with participant compliance over 90% across groups. Conclusion:: Mindfulness and tDCS offer promising non-invasive therapeutic benefit for reducing UUI symptoms in women with potential for easy dissemination and high adherence without additional pharmaceutical burden.http://www.sciencedirect.com/science/article/pii/S2772973725000220Overactive BladderUrinary Incontinence, Mindfulness, Brain Stimulation
spellingShingle Cynthia A. Conklin
Brian Coffman
Carol M. Greco
Shachi Tyagi
Becky D. Clarkson
Mindfulness and Transcranial Direct Current Stimulation (tDCS) to Attenuate Situational Urgency Urinary Incontinence (UUI): A randomized pilot study
Continence
Overactive Bladder
Urinary Incontinence, Mindfulness, Brain Stimulation
title Mindfulness and Transcranial Direct Current Stimulation (tDCS) to Attenuate Situational Urgency Urinary Incontinence (UUI): A randomized pilot study
title_full Mindfulness and Transcranial Direct Current Stimulation (tDCS) to Attenuate Situational Urgency Urinary Incontinence (UUI): A randomized pilot study
title_fullStr Mindfulness and Transcranial Direct Current Stimulation (tDCS) to Attenuate Situational Urgency Urinary Incontinence (UUI): A randomized pilot study
title_full_unstemmed Mindfulness and Transcranial Direct Current Stimulation (tDCS) to Attenuate Situational Urgency Urinary Incontinence (UUI): A randomized pilot study
title_short Mindfulness and Transcranial Direct Current Stimulation (tDCS) to Attenuate Situational Urgency Urinary Incontinence (UUI): A randomized pilot study
title_sort mindfulness and transcranial direct current stimulation tdcs to attenuate situational urgency urinary incontinence uui a randomized pilot study
topic Overactive Bladder
Urinary Incontinence, Mindfulness, Brain Stimulation
url http://www.sciencedirect.com/science/article/pii/S2772973725000220
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