The Value of Urinary BDNF Levels on Assessment of the Botulinum Toxin Type A Treatment for Neurogenic Detrusor Overactivity in Children with Myelodysplasia

Abstract

PurposeUrinary cytokines are proposed to predict the urodynamic findings and outcome of intradetrusor botulinum neurotoxin type A injection (iBoNT-Ai) in children with myelodysplasia. The relationship between urinary brain-derived neurotrophic factor (BDNF) and neurogenic and non-neurogenic detrusor overactivity (NDOA) has been shown, as well. In this prospective study, we aimed to investigate the effect of iBoNT-Ai on urine BDNF levels in children with NDOA due to myelodysplasia. Material and MethodsUrine samples of children with NDOA due to myelodysplasia were collected and analyzed, before and after iBoNT-Ai (first and third months) along with urodynamics before and 6 week after iBoNT-Ai. BDNF levels and urodynamic findings were analyzed and statistical comparisons were done. ResultsMean age was 100.0 ± 34.5 months. Rate of girls/boys was 2.8 in 23 children. BDNF levels significantly declined (p<0.006), maximum cystometric capacity and maximum detrusor pressure significantly improved following iBoNT-Ai compared to preoperative levels (p<0.001). No statistical correlations were determined between BDNF levels and urodynamics. Of all analysis, only patients with a bladder compliance of 5 mL/cmH2O or less at the postoperative urodynamics had statistically high urine BDNF levels compared to the ones above 5 mL/cmH2O, suggesting high urine BDNF to predict treatment failure. ConclusionsPresent study can hardly suggest urine BDNF to be a follow-up marker in children with NDOA due to myelodysplasia. However, it has an obscure role in treatment planning which needs to be revealed with large-numbered future prospective studies.