PD04-02 SUPRASPINAL CONTROL VARIAITONS IN MULTIPLE SCLEROSIS PATIENTS WHO VOID SPONTANOUSLY VERUS PATIENTS WITH VOIDING DYSFUNCTION

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction I1 Apr 2018PD04-02 SUPRASPINAL CONTROL VARIAITONS IN MULTIPLE SCLEROSIS PATIENTS WHO VOID SPONTANOUSLY VERUS PATIENTS WITH VOIDING DYSFUNCTION Rose Khavari, Christof Karmonik, and Timothy Boone Rose KhavariRose Khavari More articles by this author , Christof KarmonikChristof Karmonik More articles by this author , and Timothy BooneTimothy Boone More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.280AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In this study, we seek to compare brain activity processes at the time of initiation of voiding in Multiple Sclerosis (MS) patients who are voiders versus patients with voiding dysfunction. We hypothesize that female MS patients with voiding dysfunction have a distinct Blood Oxygen Level Dependent (BOLD) pattern activation in specific a priori regions of interest (ROIs) at the time of initiation of voiding when compared to patients who void spontaneously. METHODS Twenty seven ambulatory female MS patients with lower urinary tract dysfunction were recruited for this IRB approved study: Group 1; voiders (n=15) and group 2; voiding dysfunction (n=12) which was defined as patients with postvoid residual urine of = 40% of their maximum cystometric capacity or patients who performed self-catheterization. We recorded brain activity via fMRI with simultaneous urodynamic testing (UDS). From the transformed datasets, average fMRI activation maps (student t-test) for both groups were created, and areas of significant activation were identified (p<0.05). A priori ROIs identified by a prior meta-analysis to be involved in voiding were selected. RESULTS Group-averaged BOLD activation maps indicated distinct differences in activation patterns between groups (figure 1a). A reversed (negative) BOLD effect was noted in the PMC, PAG, left cingulate, left thalamus and the reticular formation. Interpretation of results Earlier positron emission topography studies have identified right dorsomedial pontine tegmentum and the right inferior frontal gyrus to be associated with significantly increased blood flow in healthy women at the time of voiding. Our results are consistent with these preliminary data in the literature where PMC, PAG, left cingulate, left thalamus and the reticular formation seem to have different pattern of activation between female MS voiders and the ones with voiding dysfunction. CONCLUSIONS Our preliminary group and network analyses demonstrate that distinct supraspinal patterns of activation and deactivation exists between MS patients who are voiders and who have voiding dysfunction. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e77-e78 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Rose Khavari More articles by this author Christof Karmonik More articles by this author Timothy Boone More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...