Structural Changes in Brain White Matter Tracts Associated with Overactive Bladder Revealed by Diffusion Tensor Magnetic Resonance Imaging: Findings from a Symptoms of Lower Urinary Tract Dysfunction Research Network Cross-Sectional Case-Control Study

H. Henry Lai, Jerrel Rutlin, Abigail R. Smith, Margaret E. Helmuth, James A. Hokanson, Claire C. Yang, J. Quentin Clemens, Vincent A. Magnotta, C. Emi Bretschneider, Kimberly Kenton, John O.L. Delancey, Karen John, Ziya Kirkali, Joshua S. Shimony, Cindy Amundsen, Eric Jelovsek, Kathryn Flynn, Jim Hokanson, Aaron Lentz, David PageNazema Siddiqui, Kevin Weinfurt, Lisa Wruck, Paige Green, Magaly Guerrero, Catherine S. Bradley, Karl Kreder, Bradley A. Erickson, Daniel Fick, Philip Polgreen, Sarah Heady, Chelsea Poesch, Shelly Melton, Jean Walshire, James W. Griffith, Brian Helfand, Carol Bretschneider, David Cella, Sarah Collins, Julia Geynisman-Tan, Alex Glaser, Christina Lewicky-Gaupp, Margaret Mueller, Sylwia Clarke, Melissa Marquez, Michelle Taddeo, Pooja Sharma, Malgorzata Antoniak, Pooja Talaty, Francesca Moroni, Sophia Kallas, Quentin Clemens, Dee Fenner, Rick Harris, Steve Harte, Anne P. Cameron, Aruna Sarma, Giulia Lane, Ashly Chimner, Linda Drnek, Emma Keer, Marissa Moore, Greg Mowatt, Sarah Richardson, Julia Chilimigras, Anna Kirby, Brenda Vicars, Lauren Daniels, Gerald L. Andriole, Fuhai Li, Linda Black, Vivien Gardner, Patricia Hayden, Diana Wolff, Aleksandra Klim, Robert Merion, Victor Andreev, Brenda Gillespie, Melissa Fava, Melissa Sexton, Jon Wiseman, Jane Liu, Levi Hurley, Christopher Mullins, Julie Barthold

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose:Our objective was to investigate structural changes in brain white matter tracts using diffusion tensor imaging (DTI) in patients with overactive bladder (OAB).Materials and Methods:Treatment-seeking OAB patients and matched controls enrolled in the cross-sectional case-control LURN (Symptoms of Lower Urinary Tract Dysfunction Research Network) Neuroimaging Study received a brain DTI scan. Microstructural integrity of brain white matter was assessed using fractional anisotropy (FA) and mean diffusivity. OAB and urgency urinary incontinence (UUI) symptoms were assessed using the OAB Questionnaire Short-Form and International Consultation on Incontinence Questionnaire-Urinary Incontinence. The Lower Urinary Tract Symptoms Tool UUI questions and responses were correlated with FA values.Results:Among 221 participants with evaluable DTI data, 146 had OAB (66 urinary urgency-only without UUI, 80 with UUI); 75 were controls. Compared with controls, participants with OAB showed decreased FA and increased mean diffusivity, representing greater microstructural abnormalities of brain white matter tracts among OAB participants. These abnormalities occurred in the corpus callosum, bilateral anterior thalamic radiation and superior longitudinal fasciculus tracts, and bilateral insula and parahippocampal region. Among participants with OAB, higher OAB Questionnaire Short-Form scores were associated with decreased FA in the left inferior fronto-occipital fasciculus, P <.0001. DTI differences between OAB and controls were driven by the urinary urgency-only (OAB-dry) but not the UUI (OAB-wet) subgroup.Conclusions:Abnormalities in microstructural integrity in specific brain white matter tracts were more frequent in OAB patients. More severe OAB symptoms were correlated with greater degree of microstructural abnormalities in brain white matter tracts in patients with OAB.Trial Registration:ClinicalTrials.gov: NCT02485808.

Original languageEnglish
Pages (from-to)351-361
Number of pages11
JournalJournal of Urology
Volume212
Issue number2
DOIs
StatePublished - Aug 1 2024

Keywords

  • brain MRI
  • diffusion tensor imaging
  • overactive bladder
  • urgency urinary incontinence

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