机构：[1]Department of Neurology, Xuan Wu Hospital of Capital Medical University, Beijing 100053, China神经科系统神经内科首都医科大学宣武医院[2]Department of Brain Repair and Rehabilitation, Faculty of Brain Sciences, Queen Square Institute of Neurology, University College London, London WC1E 6BT, UK[3]Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK[4]NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London WC1E 6BT, UK[5]Department of Neuro-Urology, Balgrist University Hospital, University of Zurich, 8006 Zurich, Switzerland[6]Centre for Medical Image Computing (CMIC), Department of Medical Physics and Biomedical Engineering, University College London, London WC1E 6BT, UK[7]School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK[8]Dementia Research Centre, Institute of Neurology, University College London, London WC1E 6BT, UK[9]Department of Electrical, Computer and Biomedical Engineering, University of Pavia, 27100 Pavia, Italy[10]School of Artificial Intelligence, Beijing University of Post and Communications, Beijing 100876, China[11]Department of Computer Science and Centre for Medical Image Computing, University College London, London WC1E 6BT, UK[12]e-Health Centre, Universitat Oberta de Catalunya, 08018 Barcelona, Spain[13]Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy[14]Digital Neuroscience Centre, IRCCS Mondino Foundation, 27100 Pavia, Italy
Lower urinary tract (LUT) symptoms are reported in more than 80% of patients with multiple sclerosis (MS), most commonly an overactive bladder (OAB). The relationship between brain white matter (WM) changes in MS and OAB symptoms is poorly understood.We aim to evaluate (i) microstructural WM differences across MS patients (pwMS) with OAB symptoms, patients without LUT symptoms, and healthy subjects using diffusion tensor imaging (DTI), and (ii) associations between clinical OAB symptom scores and DTI indices.Twenty-nine female pwMS [mean age (SD) 43.3 years (9.4)], including seventeen with OAB [mean age (SD) 46.1 years (8.6)] and nine without LUT symptoms [mean age (SD) 37.5 years (8.9)], and fourteen healthy controls (HCs) [mean age (SD) 48.5 years (20)] were scanned in a 3T MRI with a DTI protocol. Additionally, clinical scans were performed for WM lesion segmentation. Group differences in fractional anisotropy (FA) were evaluated using tract-based spatial statistics. The Urinary Symptom Profile questionnaire assessed OAB severity.A statistically significant reduction in FA (p = 0.004) was identified in microstructural WM in pwMS, compared with HCs. An inverse correlation was found between FA in frontal and parietal WM lobes and OAB scores (p = 0.021) in pwMS. Areas of lower FA, although this did not reach statistical significance, were found in both frontal lobes and the rest of the non-dominant hemisphere in pwMS with OAB compared with pwMS without LUT symptoms (p = 0.072).This study identified that lesions affecting different WM tracts in MS can result in OAB symptoms and demonstrated the role of the WM in the neural control of LUT functions. By using DTI, the association between OAB symptom severity and WM changes were identified, adding knowledge to the current LUT working model. As MS is predominantly a WM disease, these findings suggest that regional WM involvement, including of the anterior corona radiata, anterior thalamic radiation, superior longitudinal fasciculus, and superior frontal-occipital fasciculus and a non-dominant prevalence in WM, can result in OAB symptoms. OAB symptoms in MS correlate with anisotropy changes in different white matter tracts as demonstrated by DTI. Structural impairment in WM tracts plays an important role in LUT symptoms in MS.
基金：
This work was supported by the UK Multiple Sclerosis Society (Grant Ref 19). M.D.L.
received funding from the Swiss National Science Foundation (fellowship P2EZP3_148749 and
P300PB_161087), joint research funding from UCL and the Neuroscience Center Zurich, and from
the UK Multiple Sclerosis Society. B.K. is part-funded by the NIHR UCLH BRC. C.H.S. is supported
by an Alzheimer’s Society Junior Fellowship (AS-JF-17-011). G.C. is supported by an ECTRIMS
Postdoctoral Research Fellowship Program grant. J.Z. is supported by the China Scholarship Council.
F.P.C. has a non-clinical postdoctoral Guarantors of Brain fellowship. F.P.C. and B.K. are funded by
the NIHR Biomedical Research Centre at UCL/UCLH. A.T.T. is supported by the Higher Education
Funding Council for England (HEFCE). C.A.M.G.W.-K. received funding during this study from ISRT,
Wings for Life, and the Craig H. Neilsen Foundation (the INSPIRED study), from the MS Society (#77),
Wings for Life (#169111), Horizon2020 (CDS-QUAMRI, #634541), and is currently funded by BRC
(#BRC704/CAP/CGW), MRC (#MR/S026088/1), Ataxia UK, and Rosetrees Trust (#PGL22/100041
and #PGL21/10079). The work was undertaken at UCLH/UCL Institute of Neurology and JNP is
supported in part by funding from the United Kingdom’s Department of Health NIHR Biomedical
Research Centres funding scheme.
第一作者机构：[1]Department of Neurology, Xuan Wu Hospital of Capital Medical University, Beijing 100053, China[2]Department of Brain Repair and Rehabilitation, Faculty of Brain Sciences, Queen Square Institute of Neurology, University College London, London WC1E 6BT, UK[3]Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK[4]NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London WC1E 6BT, UK
通讯作者：
通讯机构：[1]Department of Neurology, Xuan Wu Hospital of Capital Medical University, Beijing 100053, China[2]Department of Brain Repair and Rehabilitation, Faculty of Brain Sciences, Queen Square Institute of Neurology, University College London, London WC1E 6BT, UK[3]Department of Uro-Neurology, The National Hospital for Neurology and Neurosurgery, London WC1N 3BG, UK[4]NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation, UCL Institute of Neurology, University College London, London WC1E 6BT, UK
推荐引用方式(GB/T 7714)：
Yang Xixi,Liechti Martina D,Kanber Baris,et al.White Matter Magnetic Resonance Diffusion Measures in Multiple Sclerosis with Overactive Bladder[J].Brain Sciences.2024,14(10):doi:10.3390/brainsci14100975.
APA：
Yang Xixi,Liechti Martina D,Kanber Baris,Sudre Carole H,Castellazzi Gloria...&Panicker Jalesh N.(2024).White Matter Magnetic Resonance Diffusion Measures in Multiple Sclerosis with Overactive Bladder.Brain Sciences,14,(10)
MLA：
Yang Xixi,et al."White Matter Magnetic Resonance Diffusion Measures in Multiple Sclerosis with Overactive Bladder".Brain Sciences 14..10(2024)
