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Association between urinary symptom severity and white matter plaque distribution in women with multiple sclerosis
Author(s) -
Smith Ariana L.,
Weissbart Steven J.,
Hartigan Siobhán M.,
Bilello Michel,
Newman Diane K.,
Wein Alan J.,
Malykhina Anna P.,
Erus Guray,
Fan Yong
Publication year - 2020
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.24206
Subject(s) - medicine , multiple sclerosis , white matter , urinary system , lesion , gyrus , urination , lobe , temporal lobe , grey matter , urology , magnetic resonance imaging , surgery , pathology , radiology , epilepsy , psychiatry
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.