Association between urinary symptom severity and white matter plaque distribution in women with multiple sclerosis.

Association between urinary symptom severity and white matter plaque distribution in women with multiple sclerosis.

Publication date: Nov 06, 2019

Multiple sclerosis (MS) is characterized by demyelinated white matter plaque throughout the central nervous system. Plaque involvement in regions that regulate micturition may be associated with urinary symptom severity in patients with MS. The aim of this prospective study is to investigate the relationship between cerebral plaque volume (PV), location, and urinary symptoms in women with MS.

We conducted a case-control pilot study of women with MS undergoing routine yearly brain MRI. Women were administered the American Urologic Association-Symptom Index (AUA-SI) and divided into two groups: severe urinary symptoms (AUA-SI ≥20) and mild symptoms (AUA-SI ≤7). PV and location in the brain were determined using a validated automated white matter lesion segmentation algorithm.

This study of 36 women found that the median total PV did not differ between groups. Women with severe urinary symptoms had larger median PV in the left frontal lobe (LFL) and right limbic lobe (RLL) compared with women with mild urinary symptoms. Within the RLL, women with severe symptoms had a larger median PV in the right cingulate gyrus (RCG). There was a moderate correlation between LFL lesion volume and RLL lesion volume with the AUA emptying subscore; however, these regions did not correlate with the storage subscore.

This preliminary study found urinary symptom severity in women with MS is associated with PV in the RCG and LFL, and not total cerebral PV. These findings may explain why disease burden alone is not a predictor of severity or type of voiding dysfunction in patients with MS.

Smith, A.L., Weissbart, S.J., Hartigan, S.M., Bilello, M., Newman, D.K., Wein, A.J., Malykhina, A.P., Erus, G., and Fan, Y. Association between urinary symptom severity and white matter plaque distribution in women with multiple sclerosis. 19451. 2019 Neurourol Urodyn.

Concepts Keywords
Algorithm MRI
Brain Urology
Central Nervous System Frontal lobe
Cingulate Gyrus Multiple sclerosis
Correlation Urinary tract infection
Frontal Lobe Urinary system
Lesion Urinary bladder
Micturition Pelvis
MRI Organs
Multiple Sclerosis Medicine
RLL Medical specialties
Symptom MS
White Matter

Semantics

Type Source Name
disease MESH multiple sclerosis
gene UNIPROT CYREN
gene UNIPROT EGR3
gene UNIPROT DNMT1
gene UNIPROT CD69
disease DOID multiple sclerosis
disease DOID neurogenic bladder
disease MESH neurogenic bladder

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