Uro-neurology

Exploring the neural control of the lower urinary tract in health and disease, and researching non-surgical options for managing neurogenic bladder, bowel and sexual dysfunction

Lead:

Dr Jalesh Panicker

Research Team

Mrs Maheen Pakzad
Ms Sohier Elneil
Dr Anton Emmanuel
Dr Catherine Dalton
Dr Xavier Game
Dr Giuseppi Preziosi
Mrs Collette Haslam

Research Goals

To evaluate the central neural correlates of lower urinary tract function and dysfunction in neurogenic and idiopathic bladder conditions using advanced MR imaging techniques
To investigate novel treatments for the management of bladder problems in patients with neurological disease
To explore the mechanisms of action of treatments for neurogenic bladder dysfunction, such as detrusor injections of botulinum toxin and tibial nerve stimulation
To study bladder and sexual dysfunction across different progressive neurological disorders
To understand the basis for lower urinary tract dysfunction in Parkinson’s Disease, including the mechanisms responsible for nocturia
To explore novel treatment for the prevention of urinary tract infections in patients with neurological disease
To explore the interface between functional urological disorders and psychological co-morbidities
To identify physiological phenotypes of gut dysfunction and develop a targeted therapy

Funded Rsesearch Projects

Exploring Melatonin for the management of nocturia in Parkinson’s Disease. Funded by Parkinson’s UK
The central control of lower urinary tract functions in patients with neurogenic and idiopathic lower urinary tract dysfunction; Collaborative study with University of Zurich. Funded by Multiple Sclerosis Society, UCL-ZNZ Neurosciences Award
The Neurological and Urological Symptoms Study- collaboration with University of Edinburgh
Exploring the causes for non-surgical urinary retention
Exploring the role of PTNS (percutaneous tibial nerve stimulation) for the management of overactive bladder symptoms in neurological patients

Recent publications from Uroneurology: 2020
Slam A, Simeoni S, Panicker J, Batla A
Exploratory pilot study exploring clinical effects of exogenous sustained-release Melatonin on nocturia in Parkinson’s Disease
European Journal of Neurology 01 Dec 2020
Hoeritzauer I, Carson A, Statham P, Panicker JN, Granitsiotis V, Eugenicos M, Summers D, Demetriades AK, Stone J
Scan-negative" cauda equina syndrome: A prospective cohort study.
Neurology 11 Nov 2020
https://doi.org/10.1212/WNL.0000000000011154
Li V, Malladi P, Simeoni S, Pakzad M, Everett R, Satukijchai C, Leite MI, Palace J, Panicker JN
A clinico-neurophysiological study of urogenital dysfunction in MOG-antibody transverse myelitis.
Neurology 95(21):e2924-e2934 24 Nov 2020
https://doi.org/10.1212/WNL.0000000000011030
Li V, Barker N, Curtis C, Porter B, Panicker JN, Chataway J, Pakzad M
The prevention and management of hospital admissions for urinary tract infection in patients with multiple sclerosis
Multiple Sclerosis and Related Disorders 45:102432
https://doi.org/10.1016/j.msard.2020.102432
Panicker JN
Neurogenic Bladder: Epidemiology, Diagnosis, and Management
Seminars in Neurology 40(5):569-579 01 Oct 2020
DOI: 10.1055/s-0040-1713876
Roy HA, Nettleton J, Blain C, Dalton C, Farhan B, Fernandes A, Georgopoulos P, Klepsch S, Lavelle J, Martinelli E, Panicker JN, Radoja I, Rapidi C-A, Pereira e Silva R, Tudor K, Wagg AS, Drake MJ
Assessment of patients with lower urinary tract symptoms where an undiagnosed neurological disease is suspected: A report from an International Continence Society consensus working group
Neurourology and Urodynamics 04 Aug 2020
https://doi.org/10.1002/nau.24469
Li V, Panicker JN, Haslam C, Chataway J
Use of a symptom-based questionnaire to screen for the presence of significant voiding dysfunction in patients with multiple sclerosis and lower urinary tract symptoms: a pilot study
Journal of Neurology 16 Jul 2020
https://doi.org/10.1007/s00415-020-10068-2
Dunya CP, Tulek Z, Kurtuncu M, Panicker JN, Eraksoy M. Effectiveness of the transcutaneous tibial nerve stimulation and pelvic floor muscle training with biofeedback in women with multiple sclerosis for the management of overactive bladder. Multiple Sclerosis Journal, online 9^th June 2020

Haddad R, Denys P, Arlandis S, Giannantoni A, Del Popolo G, Panicker JN, De Ridder D, Pauwaert K, Van Kerrebroeck PE, Everaert K. Nocturia and nocturnal polyuria in neurological patients: from epidemiology to treatment. A systematic review of the literature. Eur Urol Focus, online 16 March 2020.

Leung LY, Shah S, Seth J, Pakzad M, Afridi S, Panicker JN. Pelvic plexiform neurofibromatosis presenting with genital numbness. Practical Neurology 20(2):165-166, 1^st April 2020

McClurg D, Panicker J, Walker RW, Cunnington A, Deane KHO, Harari D, Elders A, Booth J, Hagen S, Mason H et al. Stimulation of the tibial nerve: a protocol for a multicentred randomised controlled trial for urinary problems associated with Parkinson's disease-STARTUP. BMJ Open 2020; 10(2):e034887 17 Feb.

Panicker JN, Sakakibara R. Lower urinary tract and bowel dysfunction in neurologic disease. Continuum Lifelong Learning in Neurology 2020; 26(1):178-199.

Panicker JN, Selai C, Herve F, Rademakers K, Dmochowski R, Tarcan T, von Gontard A, Vrijens D. Psychological comorbidities and functional neurological disorders in women with idiopathic urinary retention: International Consultation on Incontinence Research Society (ICI-RS) 2019. Neurourology and Urodynamics, online 1st January 2020.

Panicker JN, Simeoni S, Miki Y, Batla A, Iodice V, Holton JL, Sakakibara R, Warner TT. Early presentation of urinary retention in multiple system atrophy: can the disease begin in the sacral spinal cord? J Neurol, online 1^st March 2020

Sakakibara R, Panicker JN, Aiba Y, Tateno F, Ogata T, Yano M, Suzuki H, Sugisaki Y, Shimizu A, Takahashi O, Simeoni S. Possible "premotor" multiple system atrophy-cerebellar form. European Neurology 83(1):80-86, 1^st May 2020

Tsuchiya A, Terayama K, Sakakibara R, Panicker J, Tatena F, Aiba Y, Haruta H, Akiba T, Ogawa A, Shimizu A et al. Urodynamic and gait analyses in multiple system atrophy. Journal of the Neurological Sciences 2020; 411: 15 April 2020.

Vahabi B, Jabr R, Fry C, McCloskey K, Everaert K, Agudela CW, Monaghan TF, Rahnama’I MS, Panicker JN, Weiss JP. CI-RS 2019 nocturia think tank: How can experimental science guide us in understanding the pathophysiology of nocturia? Neurourology and Urodynamics, online 10 January 2020.

2018
Andersson K-E, Fry C, Panicker J, Rademakers K. Which molecular targets do we need to focus on to improve lower urinary tract dysfunction? ICI-RS 2017. Neurourology and Urodynamics 2018; 37:S117-S126.

Hare N, Georgopoulos P, Philips KE, Johnson JE, Seary C, Panicker JN, Stevenson VL. Improvement in overactive bladder symptoms in patients using functional electrical stimulation of the common peroneal nerve for walking. Clinical Rehabilitation 2018; 32(10):1357-1362.

Panicker JN, Anding R, Arlandis S, Blok B, Dorrepaal C, Harding C, Marcelissen T, Rademakers K, Abrams P, Apostolidis A. Do we understand voiding dysfunction in women? Current understanding and future perspectives: ICI-RS 2017. Neurourology and Urodynamics 2018; 37:S75-S85.

Sakakibara R, Panicker J, Simeoni S, Uchiyama T, Yamamoto T, Tateno F, Kishi M, Aiba Y. Bladder dysfunction as the initial presentation of multiple system atrophy: a prospective cohort study. Clinical Autonomic Research, 2018, in press.
Sihra N, Malde S, Panicker J, ….Pakzad M. Does the appearance of the urethral pressure profile trace correlate with the sphincter EMG findings in women with voiding dysfunction? Neurourology and Urodynamics 2018; 37-2:751-757.

Tornic J, Panicker JN. The management of lower urinary tract dysfunction in multiple sclerosis. Current Neurology and Neuroscience Reports 2018; 18(8) UCL Discovery
Tudor KI, Seth JH, Liechti MD, Ochulor J, Gonzales G, Haslam C, Fox Z, Pakzad M, Panicker JN. Outcomes following percutaneous tibial nerve stimulation (PTNS) treatment for neurogenic and idiopathic overactive bladder. Clinical Autonomic Research, online 3 August 2018.

Tudor KI, Eames S, Haslam C, Chataway J, Liechti MD, Panicker JN. Identifying barriers to help-seeking for sexual dysfunction in multiple sclerosis. Journal of Neurology, online 19 Sept 2018.
2017
Apostolidis A, Wagg A, Rahnam A’I MS, Panicker JN, Brijens D, von Gontard A. Is there “brain OAB” and how can we recognize it? International Consultation on Incontinence Research Society (ICI-RS) 2017. Neurourology and Urodynamics, online February 2018.
Lad M, Parkinson MH, Rai M, Pandolfo M, Bogdanova-Mihaylova P, Walsh RA, Murphy S, Emmanuel A, Panicker J, Giunti P. Urinary, bowel and sexual symptoms in a cohort of patients with Friedreich's ataxia. Orphanet Journal of Rare Diseases 2017; 12(1):158. DOI: 10.1186/s13023-017-0709-y

Panicker JN, Anding R, Arlandis S….. Apostolidis A. Do we understand urinary retention in women? Current understanding and future perspectives: ICI-RS 2017. Neurourology and Urodynamics, in press.
Panicker J, Pakzad M, Fowler C. Fowler’s Syndrome: A primary disorder of urethral sphincter relaxation. The Obstetrician and Gynaecologist, online 31 October 2017

Youssef NA, Schneider MP, Mordasini L, Ineichen BV, Bachmann LM, Chartier-Kastler E, Panicker JN, Kessler TM. Cannabinoids for treating neurogenic lower urinary tract dysfunction in patients with multiple sclerosis: a systematic review and meta-analysis. BJU International 2017; 119(4):515-521doi: 10.1111/bju.13759. Epub 2017 Feb 23.
2016
Batla A, Tayim N, Pakzad M, Panicker JN. Treatment Options for Urogenital Dysfunction in Parkinson's Disease. Curr Treat Options Neurol. 2016 Oct;18(10):45. doi: 10.1007/s11940-016-0427-0.
Phé V, Pakzad M, Haslam C, Gonzales G, Curtis C, Porter B, Chataway J, Panicker JN. Open label feasibility study evaluating D-mannose combined with home-based monitoring of suspected urinary tract infections in patients with multiple sclerosis. Neurourol Urodyn. 2017 Sep;36(7):1770-1775. doi: 10.1002/nau.23173. Epub 2016 Nov 4.
Tudor KI, Sakakibara R, Panicker JN. Neurogenic lower urinary tract dysfunction: evaluation and management. J Neurol. 2016 Dec; 263(12):2555-2564.doi:10.1007/s00415-016-8212-2

Further information

* Sihra N, Malde S, Panicker J et al. Does the appearance of the urethral pressure profile trace correlate with the sphincter EMG findings in women with voiding dysfunction? Neurourology and Urodynamics, online 5 July 2017, 10.1002/nau.23341