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    Brain activity in OAB patients characterized in study

    Supraspinal control altered in overactive bladder patients, researcher reports

    Munich, Germany—Preliminary findings of a Swiss study revealed that the brain activity associated with the desire to void in response to the automated, repetitive filling and distention of the bladder with body warm saline differed greatly between healthy patients and patients with non-neurogenic overactive bladder (NNOAB).

    Matthias Walter, MDDr. WalterOAB is characterized by urinary urgency and frequency. Supraspinal control and specifically sensory processing become altered in patients with OAB, according to first author Matthias Walter, MD, research fellow in neuro-urology at the University of Zürich, Balgrist University Hospital, Zürich, Switzerland.

    The study, which was presented at the European Association of Urology annual congress in Munich, Germany, included 24 right-handed female participants, of whom 12 had a diagnosis of OAB and 12 were healthy subjects who were matched for age and gender. This was a block design functional magnetic resonance imaging (fMRI) study that acquired neuroimaging data with the use of a 3 Tesla MR scanner. The scan paradigm comprised automated, repetitive bladder filling of 100 mL body warm saline within 15 s.

    The patients were catheterized and their bladders were pre-filled until a persistent desire to void was reported from each subject. Using SPM8, the blood-oxygenation-level dependent signal change during bladder filling was compared to the level at rest; ie, the pre-filled bladder.

    Dr. Walter and his colleagues observed bilateral activation in the frontal and prefrontal areas in healthy subjects, including in the inferior frontal gyrus pars triangularis (BA45), pars orbitalis (BA47), and medial frontal gyrus (BA10 and 46).

    Activation patterns in NNOAB patients included the right hemisphere: insula, supramarginal gyrus (BA40), rolandic operculum (BA44), and the postcentral gyrus (primary somatosensory cortex); the left hemisphere: superior frontal gyrus (BA8), caudate, angular gyrus (BA39); and thalamus, as well as bilateral activation patterns: middle cingulate cortex (BA24).

    Next: No group differences on whole-brain analysis

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