Novel insights of vulvodynia pathophysiology from reliable and comprehensive pelvic floor muscle surface electromyography characterization: can it help predict response to botulinum toxin treatment?

Albaladejo-Belmonte, Mónica; Villa-Muñoz, Paula; Nohales-Alfonso, F.J.; Novillo-Del Álamo, Blanca; Alberola Rubio, José; Garcia-Casado, Javier|||0000-0003-1410-2721

Novel insights of vulvodynia pathophysiology from reliable and comprehensive pelvic floor muscle surface electromyography characterization: can it help predict response to botulinum toxin treatment?

[EN] Background Findings on vulvodynia-associated alterations in the pelvic floor muscles' (PFMs') myoelectrical activity are contradictory, and no study has yet assessed whether they influence treatment outcomes.Aim To characterize vulvodynia-associated alterations in PFM activity...

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Autores:	Albaladejo-Belmonte, Mónica, Villa-Muñoz, Paula, Nohales-Alfonso, F.J., Novillo-Del Álamo, Blanca, Alberola Rubio, José, Garcia-Casado, Javier\|\|\|0000-0003-1410-2721
Tipo de recurso:	artículo
Fecha de publicación:	2025
País:	España
Institución:	Universitat Politècnica de València (UPV)
Repositorio:	RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
Idioma:	inglés
OAI Identifier:	oai:riunet.upv.es:10251/226593
Acceso en línea:	https://riunet.upv.es/handle/10251/226593
Access Level:	acceso abierto
Palabra clave:	Botulinum toxin Chronic pelvic pain Pelvic floor muscles Surface electromyography Vestibulodynia Vulvodynia

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network_name_str	España
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dc.title.none.fl_str_mv	Novel insights of vulvodynia pathophysiology from reliable and comprehensive pelvic floor muscle surface electromyography characterization: can it help predict response to botulinum toxin treatment?
title	Novel insights of vulvodynia pathophysiology from reliable and comprehensive pelvic floor muscle surface electromyography characterization: can it help predict response to botulinum toxin treatment?
spellingShingle	Novel insights of vulvodynia pathophysiology from reliable and comprehensive pelvic floor muscle surface electromyography characterization: can it help predict response to botulinum toxin treatment? Albaladejo-Belmonte, Mónica Botulinum toxin Chronic pelvic pain Pelvic floor muscles Surface electromyography Vestibulodynia Vulvodynia
title_short	Novel insights of vulvodynia pathophysiology from reliable and comprehensive pelvic floor muscle surface electromyography characterization: can it help predict response to botulinum toxin treatment?
title_full	Novel insights of vulvodynia pathophysiology from reliable and comprehensive pelvic floor muscle surface electromyography characterization: can it help predict response to botulinum toxin treatment?
title_fullStr	Novel insights of vulvodynia pathophysiology from reliable and comprehensive pelvic floor muscle surface electromyography characterization: can it help predict response to botulinum toxin treatment?
title_full_unstemmed	Novel insights of vulvodynia pathophysiology from reliable and comprehensive pelvic floor muscle surface electromyography characterization: can it help predict response to botulinum toxin treatment?
title_sort	Novel insights of vulvodynia pathophysiology from reliable and comprehensive pelvic floor muscle surface electromyography characterization: can it help predict response to botulinum toxin treatment?
dc.creator.none.fl_str_mv	Albaladejo-Belmonte, Mónica Villa-Muñoz, Paula Nohales-Alfonso, F.J. Novillo-Del Álamo, Blanca Alberola Rubio, José Garcia-Casado, Javier\|\|\|0000-0003-1410-2721
author	Albaladejo-Belmonte, Mónica
author_facet	Albaladejo-Belmonte, Mónica Villa-Muñoz, Paula Nohales-Alfonso, F.J. Novillo-Del Álamo, Blanca Alberola Rubio, José Garcia-Casado, Javier\|\|\|0000-0003-1410-2721
author_role	author
author2	Villa-Muñoz, Paula Nohales-Alfonso, F.J. Novillo-Del Álamo, Blanca Alberola Rubio, José Garcia-Casado, Javier\|\|\|0000-0003-1410-2721
author2_role	author author author author author
dc.contributor.none.fl_str_mv	Departamento de Ingeniería Electrónica Escuela Técnica Superior de Ingeniería Industrial Centro de Investigación e Innovación en Bioingeniería Generalitat Valenciana Universitat Politècnica de València Repositorio Institucional de la Universitat Politècnica de València Riunet
dc.subject.none.fl_str_mv	Botulinum toxin Chronic pelvic pain Pelvic floor muscles Surface electromyography Vestibulodynia Vulvodynia
topic	Botulinum toxin Chronic pelvic pain Pelvic floor muscles Surface electromyography Vestibulodynia Vulvodynia
description	[EN] Background Findings on vulvodynia-associated alterations in the pelvic floor muscles' (PFMs') myoelectrical activity are contradictory, and no study has yet assessed whether they influence treatment outcomes.Aim To characterize vulvodynia-associated alterations in PFM activity and assess its potential to predict the response to botulinum toxin type A (BoNT/A) treatment.Methods This prospective, non-masked, and non-randomized study recruited 35 vulvodynia patients who underwent BoNT/A injections and 35 healthy women. Their left and right PFM activity was monitored by surface electromyography (sEMG) with 2 recording modalities (intravaginal probe and external electrodes) during PFM contractions and rest and compared across groups at baseline. Clinical information was also collected from their medical history, pelvic physical examination, and self-informed clinical questionnaires. Both sEMG and clinical features were used to predict the patient's response to treatment using multiple binary logistic regression models.Outcomes sEMG signals' root mean square (RMS), median frequency (MDF), sample entropy (SampEn), intramuscular and intermuscular magnitude-squared coherence (mscoh) and imaginary part of their coherency (iCOH), and clinical outcomes (sociodemographic, obstetric, gynecological, urological, and other general clinical characteristics; painful comorbidities; pelvic and vulvar pain sensitivity; Patient's Global Impression of Improvement).Results Vulvodynia patients exhibited significantly lower intensity during contractions (mscoh) during contractions (P = .004) and rest (P = .006) in the myoelectrical activity of their left superficial PFM (sEMG from external electrodes) and altered intermuscular coupling during contractions (>mscoh, P = .004) in their deep PFM (sEMG from intravaginal probe) than healthy women. Furthermore, intramuscular coupling at rest was significantly associated with response to treatment (P < .01) and predicted it accurately when combined with clinical information (AUC = 0.95).Clinical Implications PFM sEMG can provide valuable insights into vulvodynia pathophysiology and help optimize treatment selection, potentially reducing the economic and psychological impact of ineffective treatment.Strengths and Limitations This study provides a reliable and comprehensive description of PFM myoelectrical activity alterations in vulvodynia conditions, demonstrating for the first time that sEMG information can improve the prediction of treatment response. It is limited by a small sample size of intravaginal probe recordings due to pain elicited by probes during their insertion and signal quality.Conclusion Vulvodynia is associated with decreased activity intensity in the superficial PFM and altered electrical coupling, as shown by sEMG, which can enhance the precision of BoNT/A treatment response prediction and thus reduce the economic and psychological burden of ineffective treatment.
publishDate	2025
dc.date.none.fl_str_mv	2025 2025-09-01
dc.type.none.fl_str_mv	journal article http://purl.org/coar/resource_type/c_6501 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv	info:eu-repo/semantics/article
format	article
dc.identifier.none.fl_str_mv	https://riunet.upv.es/handle/10251/226593
url	https://riunet.upv.es/handle/10251/226593
dc.language.none.fl_str_mv	Inglés eng
language_invalid_str_mv	Inglés
language	eng
dc.relation.none.fl_str_mv	Generalitat Valenciana https://doi.org/10.13039/501100003359 ACIF%2F2021%2F012 Generalitat Valenciana https://doi.org/10.13039/501100003359 AICO%2F2021%2F126
dc.rights.none.fl_str_mv	open access http://purl.org/coar/access_right/c_abf2 Reconocimiento - No comercial (by-nc) http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv	info:eu-repo/semantics/openAccess
rights_invalid_str_mv	open access http://purl.org/coar/access_right/c_abf2 Reconocimiento - No comercial (by-nc) http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv	openAccess
dc.format.none.fl_str_mv	application/pdf
dc.publisher.none.fl_str_mv	Oxford University Press
publisher.none.fl_str_mv	Oxford University Press
dc.source.none.fl_str_mv	reponame:RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia instname:Universitat Politècnica de València (UPV)
instname_str	Universitat Politècnica de València (UPV)
reponame_str	RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
collection	RiuNet. Repositorio Institucional de la Universitat Politécnica de Valéncia
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling	Novel insights of vulvodynia pathophysiology from reliable and comprehensive pelvic floor muscle surface electromyography characterization: can it help predict response to botulinum toxin treatment?Albaladejo-Belmonte, MónicaVilla-Muñoz, PaulaNohales-Alfonso, F.J.Novillo-Del Álamo, BlancaAlberola Rubio, JoséGarcia-Casado, Javier\|\|\|0000-0003-1410-2721Botulinum toxinChronic pelvic painPelvic floor musclesSurface electromyographyVestibulodyniaVulvodynia[EN] Background Findings on vulvodynia-associated alterations in the pelvic floor muscles' (PFMs') myoelectrical activity are contradictory, and no study has yet assessed whether they influence treatment outcomes.Aim To characterize vulvodynia-associated alterations in PFM activity and assess its potential to predict the response to botulinum toxin type A (BoNT/A) treatment.Methods This prospective, non-masked, and non-randomized study recruited 35 vulvodynia patients who underwent BoNT/A injections and 35 healthy women. Their left and right PFM activity was monitored by surface electromyography (sEMG) with 2 recording modalities (intravaginal probe and external electrodes) during PFM contractions and rest and compared across groups at baseline. Clinical information was also collected from their medical history, pelvic physical examination, and self-informed clinical questionnaires. Both sEMG and clinical features were used to predict the patient's response to treatment using multiple binary logistic regression models.Outcomes sEMG signals' root mean square (RMS), median frequency (MDF), sample entropy (SampEn), intramuscular and intermuscular magnitude-squared coherence (mscoh) and imaginary part of their coherency (iCOH), and clinical outcomes (sociodemographic, obstetric, gynecological, urological, and other general clinical characteristics; painful comorbidities; pelvic and vulvar pain sensitivity; Patient's Global Impression of Improvement).Results Vulvodynia patients exhibited significantly lower intensity during contractions (mscoh) during contractions (P = .004) and rest (P = .006) in the myoelectrical activity of their left superficial PFM (sEMG from external electrodes) and altered intermuscular coupling during contractions (>mscoh, P = .004) in their deep PFM (sEMG from intravaginal probe) than healthy women. Furthermore, intramuscular coupling at rest was significantly associated with response to treatment (P < .01) and predicted it accurately when combined with clinical information (AUC = 0.95).Clinical Implications PFM sEMG can provide valuable insights into vulvodynia pathophysiology and help optimize treatment selection, potentially reducing the economic and psychological impact of ineffective treatment.Strengths and Limitations This study provides a reliable and comprehensive description of PFM myoelectrical activity alterations in vulvodynia conditions, demonstrating for the first time that sEMG information can improve the prediction of treatment response. It is limited by a small sample size of intravaginal probe recordings due to pain elicited by probes during their insertion and signal quality.Conclusion Vulvodynia is associated with decreased activity intensity in the superficial PFM and altered electrical coupling, as shown by sEMG, which can enhance the precision of BoNT/A treatment response prediction and thus reduce the economic and psychological burden of ineffective treatment.This work was supported by Generalitat Valenciana in Programa para la promocion de I + D + i ACIF/2021/012, AICO/2021/126; and by unrestricted funding from Merz Pharma GmbH & Co. Funding for open access charge: CRUE-Universitat Politecnica de Valencia. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.Oxford University PressDepartamento de Ingeniería ElectrónicaEscuela Técnica Superior de Ingeniería IndustrialCentro de Investigación e Innovación en BioingenieríaGeneralitat ValencianaUniversitat Politècnica de ValènciaRepositorio Institucional de la Universitat Politècnica de València Riunet20252025-09-01journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://riunet.upv.es/handle/10251/226593reponame:RiuNet. Repositorio Institucional de la Universitat Politécnica de Valénciainstname:Universitat Politècnica de València (UPV)InglésengGeneralitat Valenciana https://doi.org/10.13039/501100003359 ACIF%2F2021%2F012Generalitat Valenciana https://doi.org/10.13039/501100003359 AICO%2F2021%2F126open accesshttp://purl.org/coar/access_right/c_abf2Reconocimiento - No comercial (by-nc) http://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:riunet.upv.es:10251/2265932026-06-13T07:49:27Z
score	15,81155

Novel insights of vulvodynia pathophysiology from reliable and comprehensive pelvic floor muscle surface electromyography characterization: can it help predict response to botulinum toxin treatment?

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