Journal article
Naturalistic Bladder Filling Reveals Subtypes in Overactive Bladder Syndrome That Differentially Engages Urinary Urgency-Related Brain Circuits: Results From the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN)
The Journal of urology, Vol.11(1), pp.111-123
01/2024
DOI: 10.1097/JU.0000000000003699
PMID: 37796776
Abstract
Purpose: Overactive bladder (OAB) may be attributed to dysfunction in supraspinal brain circuits. Overactive bladder participants enrolled in the LURN (Symptoms of Lower Urinary Tract Dysfunction Research Network) study reported sensations of urinary urgency during a bladder-filling paradigm while undergoing brain functional MRI to map supraspinal dysfunction.
Materials and methods: OAB participants and controls (CONs) completed 2 resting-state functional MRI scans following consumption of 350 mL water. Scans were conducted at fuller and emptier bladder states, interleaved with voiding. Urgency ratings (0-10) were assessed. Patterns of urgency during bladder filling were investigated using latent class trajectory models. Clusters of participants encompassing each pattern (ie, subtype) were derived from aggregated groups of OAB and CON independent of diagnosis.
Results: Two distinct patterns of urgency trajectories were revealed: first subtype with OAB and CON who were unresponsive to bladder filling (OAB-1 and CON-1) and second highly responsive subtype predominantly containing OAB (OAB-2). OAB-2 participants scored significantly higher on urinary symptoms but not pain or psychosocial measures. Neuroimaging analyses showed change in urgency due to both bladder filling and voided volume related to multiple loci of brain network connectivity in OAB-2, and in some cases, different than OAB-1 and/or CON-1. Sensorimotor to dorsomedial/dorsolateral prefrontal connectivity mediated the relationship between stimulus (voided volume) and percept (urgency) in OAB-2.
Conclusions: Our results reveal different OAB subtypes with latent class trajectory models of urgency ratings during natural bladder filling. Functional MRI revealed differences in pathophysiology between subtypes, namely sensorimotor-prefrontal connectivity is a key locus in OAB patients with higher urinary symptoms.
Details
- Title: Subtitle
- Naturalistic Bladder Filling Reveals Subtypes in Overactive Bladder Syndrome That Differentially Engages Urinary Urgency-Related Brain Circuits: Results From the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN)
- Creators
- Ishtiaq Mawla - University of Michigan–Ann ArborAndrew Schrepf - University of Michigan–Ann ArborJason J. Kutch - University of Southern CaliforniaMargaret E. Helmuth - Arbor Research Collaborative for HealthAbigail R. Smith - Arbor Research Collaborative for HealthEric Ichesco - University of Michigan–Ann ArborClaire C. Yang - University of WashingtonVictor P. Andreev - Arbor Research Collaborative for HealthKarl J. Kreder - University of IowaCatherine S. Bradley - University of IowaVincent A. Magnotta - University of IowaZiya Kirkali - National Institute of Diabetes and Digestive and Kidney DiseasesRichard E. Harris - University of Michigan–Ann ArborH. Henry Lai - Washington University in St. LouisSteven E. Harte - University of Michigan–Ann Arbor
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.11(1), pp.111-123
- DOI
- 10.1097/JU.0000000000003699
- PMID
- 37796776
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Electronic publication date
- 10/05/2023
- Date published
- 01/2024
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Psychiatry; Epidemiology; Iowa Neuroscience Institute; Obstetrics and Gynecology; Urology
- Record Identifier
- 9984474692202771
Metrics
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