Abnormal dynamics of functional connectivity density and effective connectivity in overactive bladder.

Area of Science:

• Neuroscience
• Medical Imaging
• Urology

Background:

• Overactive bladder (OAB) is a condition characterized by urinary urgency.
• The neural mechanisms underlying OAB pathophysiology remain incompletely understood.
• Functional magnetic resonance imaging (fMRI) offers insights into brain activity and connectivity.

Purpose of the Study:

• To investigate alterations in dynamic functional connectivity density (dFCD) and dynamic effective connectivity (dEC) in female OAB patients compared to healthy controls (HC).
• To identify distinct neural communication patterns associated with OAB using fMRI.
• To explore the potential neural underpinnings of OAB symptoms.

Main Methods:

• Resting-state fMRI data acquired from 43 female OAB patients and 40 female HC.
• Sliding window correlation applied to assess dFCD variability.
• Granger causal analysis and k-means clustering used to examine dFCD-based dEC and identify connectivity states.

Main Results:

• OAB patients exhibited decreased dFCD in the left anterior cingulate cortex (ACC) and left medial prefrontal cortex (mPFC) compared to HC.
• Distinct dEC patterns were observed in OAB patients, including altered connections involving the ACC, mPFC, supplementary motor area (SMA), and dorsolateral prefrontal cortex (dlPFC).
• Specific state-dependent changes in excitatory and inhibitory connections were identified in OAB participants.

Conclusions:

• OAB patients display significant alterations in dynamic functional and effective brain connectivity.
• These connectivity changes suggest distinct neural mechanisms contributing to OAB pathophysiology.
• fMRI-based connectivity analysis provides valuable information for understanding OAB.