Neurology, Internal Medicine, Sakura Medical Center, Toho University, Sakura, Japan.
Clinical Physiology Unit, Sakura Medical Center, Toho University, Sakura, Japan.
Auton Neurosci. 2020 Dec;229:102719. doi: 10.1016/j.autneu.2020.102719. Epub 2020 Aug 26.
The urodynamics underlying lower urinary tract (LUT) dysfunction in frontotemporal lobar degeneration (FTLD) has not been reported. Herein, we investigated LUT function in FTLD patients by performing a urodynamics analysis.
We recruited five FTLD patients with LUT symptoms: three men, two women; mean age, 70.4 years; mean disease duration, 3.8 years; mean Hoehn-Yahr grade 1.0. We administered a urinary symptom questionnaire and performed a urodynamics study in each patient.
LUT symptoms were observed in all patients. Urinary urgency/frequency (also called overactive bladder, OAB) was noted in all; OAB wet in three (60%) and mild voiding difficulty in two (40%). The urodynamic abnormalities included detrusor overactivity in four (80%), increased bladder sensation in two, large post-void residual in one (comorbid spondylosis), and latent detrusor underactivity in two. None had apparent outlet obstruction or detrusor-sphincter dyssynergia. Sphincter electromyography was normal in the cases studied.
We observed detrusor overactivity in FTLD patients with LUT symptoms. Although a preliminary observation, this LUT feature, which might reflect the frontal/insular cortex pathology typically associated with FTLD, requires appropriate management and care.
额颞叶变性（FTLD）患者下尿路（LUT）功能障碍的尿动力学基础尚未报道。在此，我们通过尿动力学分析研究了 FTLD 患者的 LUT 功能。
我们招募了 5 名有 LUT 症状的 FTLD 患者：3 名男性，2 名女性；平均年龄 70.4 岁；平均病程 3.8 年；平均 Hoehn-Yahr 分级 1.0。我们对每位患者进行了尿症状问卷调查和尿动力学研究。
所有患者均出现 LUT 症状。所有患者均出现尿急/频（也称膀胱过度活动症，OAB）；3 名（60%）为 OAB 湿，2 名（40%）为轻度排尿困难。尿动力学异常包括 4 名（80%）逼尿肌过度活动，2 名逼尿肌感觉增加，1 名（合并颈椎病）有较大的残余尿量，2 名有潜在的逼尿肌功能不足。均无明显出口梗阻或逼尿肌括约肌协同失调。研究的病例中括约肌肌电图正常。
我们观察到有 LUT 症状的 FTLD 患者存在逼尿肌过度活动。虽然这是初步观察，但这种 LUT 特征可能反映了与 FTLD 相关的额/岛叶皮质病理，需要进行适当的管理和护理。
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