Ariana L Smith1, Steven J Weissbart2, Siobhán M Hartigan3, Michel Bilello4, Diane K Newman1, Alan J Wein1, Anna P Malykhina5, Guray Erus6, Yong Fan6. 1. Division of Urology, Perelman School of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania. 2. Department of Urology, School of Medicine, Stony Brook University, New York, New York. 3. Department of Urology, Vanderbilt University, Nashville, Tennessee. 4. Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania. 5. Division of Urology, University of Colorado Denver, Aurora, Colorado. 6. Department of Radiology, Center for Biomedical Image Computing and Analytics (CBICA), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Abstract
AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: J van Heerden; D Rawlinson; A M Zhang; R Chakravorty; M A Tacey; P M Desmond; F Gaillard Journal: AJNR Am J Neuroradiol Date: 2015-06-18 Impact factor: 3.825
Authors: A Traboulsee; J H Simon; L Stone; E Fisher; D E Jones; A Malhotra; S D Newsome; J Oh; D S Reich; N Richert; K Rammohan; O Khan; E-W Radue; C Ford; J Halper; D Li Journal: AJNR Am J Neuroradiol Date: 2015-11-12 Impact factor: 3.825
Authors: Jimit Doshi; Guray Erus; Yangming Ou; Susan M Resnick; Ruben C Gur; Raquel E Gur; Theodore D Satterthwaite; Susan Furth; Christos Davatzikos Journal: Neuroimage Date: 2015-12-08 Impact factor: 6.556