Abnormal Cerebral Perfusion and Functional Connectivity in Women with Overactive Bladder

Area of Science:

• Neuroscience
• Medical Imaging
• Urology

Background:

• Overactive bladder (OAB) is associated with altered cerebral blood flow (CBF) and functional connectivity (FC), but findings are inconsistent.
• Investigating these brain changes is crucial for understanding OAB pathophysiology.

Purpose of the Study:

• To assess the feasibility of using arterial spin labeling (ASL) to examine CBF and posterior cingulate cortex (PCC) functional connectivity (FC) in OAB patients.
• To explore brain alterations at rest and during bladder filling, and evaluate treatment effects.

Main Methods:

• ASL imaging was performed on 22 female participants (12 OAB, 10 controls) at various bladder filling volumes.
• Data were analyzed using a flexible factorial design considering group (control, OAB baseline, OAB posttreatment) and urge state (low vs. high).
• CBF and PCC FC were assessed, categorizing scans into low-urge and high-urge conditions.

Main Results:

• OAB patients showed decreased ΔCBF in the medial prefrontal cortex and increased ΔCBF in the supramarginal region compared to controls.
• Reduced ΔPCC FC with the insula was observed in OAB participants.
• Posttreatment, OAB patients exhibited increased ΔPCC FC with the postcentral and parietal (PocP) regions, correlating with symptom improvement.

Conclusions:

• ASL is a feasible method for investigating brain-bladder control mechanisms in OAB.
• Findings highlight the role of sensory processing and attention regulation in OAB.
• Treatment-induced changes in brain connectivity are linked to symptom relief in OAB.