Neurology, Internal Medicine, Sakura Medical Center, Toho University, 564-1 Shimoshizu, Sakura 285-8741, Japan.
Clin Auton Res. 2013 Apr;23(2):85-9. doi: 10.1007/s10286-013-0187-9. Epub 2013 Jan 19.
'Vascular incontinence' is a part of elderly incontinence due to cerebral white matter change (WMC). We studied the relationship between performance on several cognitive tasks and urodynamic detrusor overactivity (DO) in patients with vascular incontinence.
We recruited 40 patients with lower urinary tract symptoms due to WMC [20 male, 20 female; mean age 77 years (60-89 years)]. Other neurologic, urologic, and systemic causes of LUT dysfunction were excluded. All patients underwent urodynamics tests and two sets of cognitive tasks, i.e., the Mini-Mental State Examination (MMSE) (general cognitive tasks), and the Frontal Assessment Battery (FAB) (frontal lobe tasks).
The most common urinary symptom was urinary urgency (27 patients), followed by urinary incontinence (26) and nocturnal urinary frequency (25). The urodynamic testing revealed DO in 22 patients. The cognitive testing revealed that the patients' mean MMSE score was 25.8 (range 15-30), and their mean FAB score was 13.6 (4-18). There was no relationship between DO and the total MMSE or FAB score, but our analysis of the relationship between DO and the six subdomains of the FAB (conceptualization, mental flexibility, programming, sensitivity to interference, inhibitory control, and environmental autonomy) revealed a significant relationship between DO and the inhibitory control task (p < 0.005).
The results of the present study showed that performance on an inhibitory control task is decreased in vascular incontinence patients with DO.
“血管性失禁”是由于脑白质改变（WMC）导致的老年失禁的一部分。我们研究了认知任务表现与血管性失禁患者尿动力学逼尿肌过度活动（DO）之间的关系。
我们招募了 40 名因 WMC 出现下尿路症状的患者[20 名男性，20 名女性；平均年龄 77 岁（60-89 岁）]。排除了其他神经、泌尿科和系统原因引起的 LUT 功能障碍。所有患者均接受了尿动力学检查和两套认知任务，即简易精神状态检查（MMSE）（一般认知任务）和额叶评估测验（FAB）（额叶任务）。
最常见的尿症状是尿急（27 例），其次是尿失禁（26 例）和夜间尿频（25 例）。尿动力学检查显示 22 例患者存在 DO。认知测试显示，患者的平均 MMSE 评分为 25.8（范围 15-30），平均 FAB 评分为 13.6（4-18）。DO 与总 MMSE 或 FAB 评分之间无相关性，但我们对 DO 与 FAB 的六个子领域（概念化、思维灵活性、编程、对干扰的敏感性、抑制控制和环境自主性）之间的关系进行分析后发现，DO 与抑制控制任务之间存在显著相关性（p < 0.005）。
本研究结果表明，存在 DO 的血管性失禁患者在抑制控制任务上的表现下降。
