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Alterations in the Cerebral Perivascular Space Network as a Potential Central Mechanism in Overactive Bladder: A
Ye Hua1,2, Yuwei Zhang1,3, Feng Lu1
1Department of Urology, Department of Neurology, Department of Imaging, Physical Examination Center, Jiangnan University Medical Center, Wuxi, China.
Background And Objective:
The role of the central nervous system (CNS) in overactive bladder (OAB) is not completely understood. Our aim was to investigate the association between alterations in the brain perivascular network and OAB, and to identify potential biomarkers for future intervention trials.
Methods:
This prospective study included 131 patients with OAB and 119 healthy individuals matched for age, sex, and education. High-resolution 3.0-T magnetic resonance imaging was used to measure brain glymphatic system (BGS) markers, including white matter (WM) and subcortical perivascular space (PVS) characteristics, the free water (FW) fraction, the Analysis Along the Perivascular Space index, and the choroid plexus volume. Spearman and partial correlation analyses were used to examine relationships between imaging results and clinical data. Linear regression and partial correlation analyses for 6-mo follow-up data were conducted to assess longitudinal associations between changes in BGS parameters and OAB symptom progression.
Key Findings And Limitations:
Patients with OAB exhibited notable BGS alterations, among which the WM-PVS count and FW fraction were strongly associated with clinical questionnaire scores. At 6-mo follow-up, progression of OAB symptoms was linked to a significant increase in brain FW content. However, we did not systematically evaluate how bladder function is related to changes in specific brain regions.
Conclusions And Clinical Implications:
This study reveals for the first time an association between BGS dysfunction and OAB symptom severity. Our findings reinforce the role of the CNS in contributing to OAB and highlight potential therapeutic targets.
Patient Summary:
We used MRI (magnetic resonance imaging) brain scans and questionnaires on overactive bladder (OAB) symptoms to look at possible links between brain changes and OAB. Our results suggest that changes within the brain network may be a central mechanism in OAB. This new discovery may help in the development of new treatments for patients with OAB.
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