Considering non‐bladder aetiologies of overactive bladder: a functional neuroimaging study

• Published in: BJU international 2021-11, Vol.128 (5), p.586-597
• Main Authors: Walter, Matthias, Leitner, Lorenz, Betschart, Cornelia, Engeler, Daniel S., Freund, Patrick, Kessler, Thomas M., Kollias, Spyros, Liechti, Martina D., Scheiner, David A., Michels, Lars, Mehnert, Ulrich
• Format: Article
• Language: English
• Subjects: Adult; Age; Anxiety; Basal ganglia; Bladder; Body temperature; Brain - diagnostic imaging; Brain - physiopathology; brain activity; Brain mapping; Case-Control Studies; Cerebellum; Cognition; Cognitive ability; Cold; Cold Temperature; Cortex (cingulate); Cortex (somatosensory); Cortex (temporal); desire to void; Female; functional magnetic resonance imaging; Functional Neuroimaging; Humans; Information processing; lower urinary tract; Magnetic Resonance Imaging; Mental depression; Mental Status and Dementia Tests; Motor activity; Neuroimaging; overactive bladder; Patients; Prefrontal cortex; Questionnaires; Saline Solution; Sensory integration; Sensory perception; Superior temporal gyrus; supraspinal control; Surveys and Questionnaires; Temporal gyrus; Urinary Bladder - diagnostic imaging; Urinary Bladder - physiopathology; Urinary Bladder, Overactive - diagnostic imaging; Urinary Bladder, Overactive - etiology; Urinary Bladder, Overactive - physiopathology; Urinary incontinence; Urinary tract; Urodynamics; Urology
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/bju.15354

Objectives To better understand the neuropathophysiology of overactive bladder (OAB) in women by characterising supraspinal activity in response to bladder distention and cold stimulation. Subjects/Patients and Methods We recruited 24 female participants, 12 with OAB (median [interquartile range, IQR] age 40 [32–42] years) and 12 healthy controls (HCs) without lower urinary tract (LUT) symptoms (median [IQR] age 34 [28–44] years), and assessed LUT and cognitive function through neuro‐urological examination, 3‐day bladder diary, urodynamic investigation, and questionnaires. Functional magnetic resonance (MR) imaging using a 3‐T scanner was performed in all participants during automated, repetitive bladder filling and draining (block design) with 100 mL body temperature (37 °C) saline using a MR‐compatible and MR‐synchronised infusion–drainage device until strong desire to void (HIGH‐FILLING/DRAINING) and bladder filling with cold saline (4 °C, i.e. COLD). Whole‐brain and region‐of‐interest analyses were conducted using Statistical Parametric Mapping, version 12. Results Significant between‐group differences were found for 3‐day bladder diary variables (i.e. voiding frequency/24 h, P