Bladder dysfunction in subacute combined degeneration: a clinical, MRI and urodynamic study

Area of Science:

• Neurology
• Urology
• Nutritional Medicine

Background:

• Subacute combined degeneration (SACD) is a neurological disorder often associated with vitamin B12 deficiency.
• Micturition disturbances are not well-documented in SACD, necessitating further investigation.

Purpose of the Study:

• To investigate the prevalence and characteristics of micturition disturbances in patients with SACD.
• To correlate urinary symptoms with urodynamic and MRI findings.
• To evaluate the response to vitamin B12 therapy.

Main Methods:

• Prospective study of eight SACD patients diagnosed via clinical features and low vitamin B12 levels.
• Assessment of micturition symptoms using the American Urological Association Symptoms (AUAS) score.
• Spinal MRI and urodynamic studies were performed; patients received intramuscular vitamin B12 therapy.

Main Results:

• All patients experienced neurological symptoms, including walking difficulties and lower limb impairment.
• Five patients had storage, seven had voiding, and four had both types of urinary dysfunction (mean AUAS score 14.63).
• Urodynamic findings included detrusor areflexia and neurogenic detrusor overactivity; symptoms improved significantly (mean AUAS score 3.67) after B12 treatment, with 7/8 patients showing recovery.

Conclusions:

• Bladder symptoms are common in advanced SACD and can manifest as detrusor areflexia or neurogenic overactivity.
• Vitamin B12 therapy is effective in improving micturition disturbances associated with SACD.