Mehnert Ulrich, Walter Matthias, Leitner Lorenz, Kessler Thomas M, Freund Patrick, Liechti Martina D, Michels Lars
Department of Neuro-Urology, Balgrist University Hospital, University of Zürich, 8008 Zürich, Switzerland.
Department of Urology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland.
Biomedicines. 2023 Jun 5;11(6):1640. doi: 10.3390/biomedicines11061640.
Overactive bladder (OAB) is a global problem reducing the quality of life of patients and increasing the costs of any healthcare system. The etiology of OAB is understudied but likely involves supraspinal network alterations. Here, we characterized supraspinal resting-state functional connectivity in 12 OAB patients and 12 healthy controls (HC) who were younger than 60 years. Independent component analysis showed that OAB patients had a weaker presence of the salience (Cohen's d = 0.9) and default mode network (Cohen's d = 1.1) and weaker directed connectivity between the fronto-parietal network and salience network with a longer lag time compared to HC. A region of interest analysis demonstrated weaker connectivity in OAB compared to HC (Cohen's d > 1.6 or < -1.6), particularly within the frontal and prefrontal cortices. In addition, weaker seed (insula, ventrolateral prefrontal cortex) to voxel (anterior cingulate cortex, frontal gyrus, superior parietal lobe, cerebellum) connectivity was found in OAB compared to HC (Cohen's d > 1.9). The degree of deviation in supraspinal connectivity in OAB patients (relative to HC) appears to be an indicator of the severity of the lower urinary tract symptoms and an indication that such symptoms are directly related to functional supraspinal alterations. Thus, future OAB therapy options should also consider supraspinal targets, while neuroimaging techniques should be given more consideration in the quest for better phenotyping of OAB.
膀胱过度活动症（OAB）是一个全球性问题，它降低了患者的生活质量，并增加了任何医疗保健系统的成本。OAB的病因研究不足，但可能涉及脊髓上网络改变。在这里，我们对12名年龄小于60岁的OAB患者和12名健康对照（HC）的脊髓上静息态功能连接进行了特征描述。独立成分分析表明，与HC相比，OAB患者的突显网络（科恩d值 = 0.9）和默认模式网络（科恩d值 = 1.1）的存在较弱，额顶叶网络与突显网络之间的定向连接较弱，且滞后时间更长。感兴趣区域分析表明，与HC相比，OAB的连接性较弱（科恩d值 > 1.6或 < -1.6），尤其是在额叶和前额叶皮质内。此外，与HC相比，在OAB中发现种子点（脑岛、腹外侧前额叶皮质）到体素（前扣带回皮质、额回、顶上叶、小脑）的连接较弱（科恩d值 > 1.9）。OAB患者（相对于HC）脊髓上连接的偏差程度似乎是下尿路症状严重程度的一个指标，表明这些症状与脊髓上功能改变直接相关。因此，未来OAB的治疗选择也应考虑脊髓上靶点，而在寻求更好地表征OAB时，应更多地考虑神经成像技术。
