Abstract
BackgroundPrimary monosymptomatic nocturnal enuresis (PMNE) is a common disorder in school-aged children. Previous studies have suggested that a developmental delay might play a role in the pathology of children with PMNE. However, microstructural abnormalities in the brains of these children have not been thoroughly investigated.Methodology/Principal FindingsIn this work, we evaluated structural changes in the brains of children with PMNE using diffusion tensor imaging (DTI). Two groups consisting of 26 children with PMNE and 26 healthy controls were scanned using magnetic resonance DTI. The diffusion parameters of fractional anisotropy (FA) and mean diffusivity (MD) were subjected to whole-brain, voxel-wise group comparisons using statistical parametric mapping (SPM). When compared to healthy subjects, children with PMNE showed both a decrease in FA and an increase in MD in the thalamus. MD also increased in the frontal lobe, the anterior cingulate cortex and the insula; these areas are all involved in controlling micturition. The significant changes seen in the thalamus could affect both urine storage and arousal from sleep.Conclusions/SignificanceThe microstructure abnormalities were observed in the thalamus, the medial frontal gyrus, the anterior cingulate cortex and the insula, which are involved in micturition control network. This indicates developmental delay in these areas may be the cause of PMNE.
Highlights
Nocturnal enuresis is a common developmental disorder that affects 15–20% of 5-year-old children [1], and it has important negative effects on the self-image and performance of these children [2]
When compared to healthy subjects, children with Primary monosymptomatic nocturnal enuresis (PMNE) showed both a decrease in fractional anisotropy (FA) and an increase in mean diffusivity (MD) in the thalamus; MD increased in the medial frontal gyrus, the ACC and the insula, which are all involved in the control of micturition [8]
Previous studies have reported that FA increases and MD decreases with age throughout childhood and adolescence [15,16,17,18]
Summary
Nocturnal enuresis is a common developmental disorder that affects 15–20% of 5-year-old children [1] , and it has important negative effects on the self-image and performance of these children [2]. It has been observed that the maturational delay of the central nervous system is an important factor in the pathogenesis of nocturnal enuresis [5,6,7], because it can induce functional and structural abnormalities in some brain areas. We reported that forebrain activation was altered during a response inhibition task [11] and that spontaneous brain activity changed during the resting state in children with PMNE [12]. These functional changes may originate from a structural abnormality. Microstructural abnormalities in the brains of these children have not been thoroughly investigated
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