Primary Nocturnal Enuresis Children Research Articles

Abnormal microstructure of corpus callosum in children with primary nocturnal enuresis: a DTI study.

Primary nocturnal enuresis (PNE) is a common childhood disorder with abnormal sleep or arousal. The corpus callosum (CC) continues to develop into adulthood and plays an important role in sleep arousal. This study aimed to evaluate the microstructure of the CC in children with PNE. Diffusion tensor imaging (DTI) indices were extracted throughout the CC and its seven subregions were compared between the children with PNE and healthy children (HC). The correlation between abnormal DTI indices of the CC and cognitive condition was also tested. Compared to HC, decreased fiber number (NF) (F = 8.492, PFDR = 0.032) and fractional anisotropy (FA) value (F = 8.442, PFDR = 0.040) were found in the posterior midbody of the CC, increased RD was found in the posterior midbody (F = 6.888, PFDR = 0.040) and isthmus (F = 7.967, PFDR = 0.040) in children with PNE. The reduction of FA value was more obvious in boys than girls with PNE. In children with PNE, there was a significant positive correlation between the NF of the posterior midbody and full IQ (r = 0.322, P = 0.025) and between the FA value and the general knowledge memory (r = 0.293, P = 0.043). This study provides imaging evidence for abnormalities in the microstructure of the CC in children with PNE, especially in male PNE, which might affect the children's cognitive performance.

How Valuable is Uroflowmetry in Children with Enuresis Nocturna?

Abstract Objective: Enuresis nocturna is an important social and psychological problem in children. Uroflowmetry (UF) is a noninvasive urodynamic test that is performed in daily clinical practice to evaluate urinary function. In UF evaluation, urine amount, urination time, latency time, maximum urine flow rate access time, maximum urine flow rate, and mean urine flow rate are evaluated. The objective of the study was to evaluate the UF results of children with primary nocturnal enuresis (PNE). Materials and Methods: The UF findings of healthy and visualized children without any urinary symptoms and who were prospectively admitted to the urology and pediatric surgery outpatient clinic with the complaint of PNE were compared. Information and UF results of PNE and healthy children included in the study were recorded. In this research, we compared the clinical characteristics and features of bladder assessment: UF, postvoid residuals, and bladder wall thickness between boys and girls with PNE and the clinical characteristics and bladder assessment between children with primary and secondary PNE. Results: A total of 183 children, comprised 103 potty-trained children with PNE and 80 potty-trained healthy children were included in the study. There were 60 children in the PNE group and 62 children in the control group. There was no statistically significant difference between the groups in terms of age. When the UF findings of both groups were compared, it was found that only maximum flow was higher in the children with PNE. In other parameters, there was no difference between the two groups. The Qmax in the group with PNE and the control group was found to be 20.48 ± 6.57 ml/s and 17.22 ± 6.17 ml/s, respectively (P = 0.001). Conclusions: The present study reveals that there is no difference between patients with enuresis nocturna and healthy individuals in terms of UF. Therefore, UF is not recommended for use in differential PNE diagnosis.

The Cognitive Characteristics of PNE Children with Different Genders: A Resting-State fMRI Study.

To study the brain mechanism and behavioral performance of cognitive functional differences between children with primary nocturnal enuresis (PNE) of different genders by resting-state functional magnetic resonance imaging (rs-fMRI) and attention behavior research. All the children participating the test were 5-11 years old including 32 PNE children (15 boys and 17 girls) and 35 normal children (16 boys and 19 girls). They respectively went through MRI scan and the data were analyzed by the method of amplitude of low frequency fluctuation (ALFF). Then continuous performance test (CPT) was done and the correct number and reaction time were recorded. The between-group variance was analyzed by two sample t-test. 1. fMRI: There were no obviously different brain regions of ALFF between normal boys and girls. The brain regions which had obvious differences of ALFF between PNE boys and girls were right middle frontal gyrus, left inferior parietal lobule and right posterior cerbellar lobe. And the group of PNE boys were higher than PNE girls on all the three regions (P < 0.05). 2. CPT: The reaction time of PNE and normal boys was both lower than those of girls, but there were no obvious differences on the correct number. This study found that girls with PNE performed more obvious damages on attention, executive function and working memory than boys which might be related to the fact that girls were more likely to suffer from confidence impairment due to enuresis leading to cognitive dysfunctions. The method of ALFF based on resting-state fMRI provided a new approach for studying the cognitive characteristics of PNE children.

Sex Differences of White Matter Integrity Changes in Adolescents and Young Adults With Bipolar Disorder

Several lines of evidence indicate that multiple abnormalities of gray matter are related to the pathogenesis of primary nocturnal enuresis (PNE); however, few studies have been conducted with respect to abnormalities in white matter (WM) of children with PNE. The present work investigated the microstructure of WM in children with PNE using a neurite orientation dispersion and density imaging (NODDI) method. NODDI data were obtained from 29 children with PNE (age = 9.8 ± 1.2 years, 59% males) and 34 healthy controls (age = 10.3 ± 1.6 years, 56% males) in this study. Multi-b-value diffusion-weighted imaging data were acquired with a 3 T MR system, and the orientation dispersion index (ODI) and neurite density index (NDI) maps were calculated. Tract-Based Spatial Statistics analyses of WM tracts were performed with ODI and NDI maps in children with PNE and controls. Children with PNE had lower ODIs in WM fiber tracts of the bilateral superior longitudinal fasciculus (SLF) and higher ODIs in the bilateral internal capsule (IC) and right anterior thalamic radiation (ATR) than controls. PNE children also had lower NDIs in the bilateral IC and the cingulum and higher NDIs in the bilateral SLF. These changes in NODDI indices, which indicated abnormal neural maturation of the WM microstructures, may be related to abnormal sleep and enuresis in children with PNE.

The brain mechanism of awakening dysfunction in children with primary nocturnal enuresis based on PVT-NAc neural\xa0pathway: a resting-state fMRI study

Primary nocturnal enuresis (PNE) affects children’s physical and mental health with a high rate. However, its neural mechanism is still unclear. Studies have found that the paraventricular thalamus (PVT) is among the key brain regions implicated with awakening regulation and its control of the transition between sleep and wakening is dependent on signaling through the PVT-nucleus accumbens (NAc) pathway. So this study analyzed the function of brain regions and their connectivity of PVT and NAc. A total of twenty-six PNE and typically developing (TD) children were involved in the study and the methods of amplitude of low frequency fluctuation (ALFF), degree centrality (DC) and functional connectivity (FC) based on resting-state functional magnetic resonance imaging (rs-fMRI) were used to analyze the brain functions. Results showed that there was no statistical significant difference in ALFF and DC between PNE and TD children in bilateral PVT and NAc. And there was statistical significant difference of the comparison of the FC of left PVT (lPVT) and left NAc (lNAc) between PNE and TD children. Meanwhile, there was negative correlation between awakening score and the FC of rPVT and lNAc, and no obvious correlation between awakening score and the FC of lPVT and lNAc in PNE children. Meanwhile, there was both negative correlation between awakening score and the FC of lPVT, rPTV and lNAc in TD children. Therefore, the FC between rPVT and lNAc was more reliable in assessing the degree of awakening ability in PNE children. This finding could help establish the evaluation index of PNE.

Effect of DRD4 Receptor -616 C/G Polymorphism on Thalamic GABA Levels in Pediatric Patients With Primary Nocturnal Enuresis.

The single nucleotide polymorphism (SNP) of dopamine D4 receptor (DRD4) promoter (-616; rs747302) is associated with abnormalities of the thalamus in children suffering from primary nocturnal enuresis (PNE). To investigate the effect of DRD4 -616 C/G SNP on thalamic gamma-aminobutyric acid (GABA) levels in PNE children. Prospective, observational. One hundred and seventy-six children with PNE and 161 healthy control children. 3 T, three-dimensional T1-weighted turbo field echo sequence and MEscher-Garwood Point RESolved Spectroscopy (MEGA-PRESS) MRS sequence. The MEGA-PRESS MRS sequence was used to measure thalamic GABA spectra. The thalamic GABA+ level was calculated using the Gannet 3.0 software package for each participant. A questionnaire was used to determine arousal from sleep (AS) scores. Comparisons of the AS scores and thalamic GABA+ levels were performed using the Mann-Whitney U test between C-allele carriers and GG homozygotes in the PNE and control groups. Spearman correlation analysis was performed to determine the association between AS scores and thalamic GABA levels in PNE children. Thalamic GABA levels in the PNE group were significantly higher than those in the healthy control group (0.178 (0.169-0.186) vs. 0.154 (0.146-0.164), Z=8.526, Pcorrected < 0.001). The GABA levels in C-allele carriers were significantly higher than those in GG homozygotes in both the PNE and control groups (0.184 (0.181-0.193) vs. 0.170 (0.165-0.177), Z=8.683, Pcorrected < 0.001; 0.166 (0.156-0.170) vs. 0.147 (0.141-0.152), Z=9.445, Pcorrected < 0.001). GABA levels in the thalamus were also significantly and positively correlated with AS scores in C-allele carriers in the PNE group (r=0.747, P < 0.05). DRD4 -616 C allele may be associated with increased thalamic GABA+ levels, especially in C-allele carrying PNE children. 2 TECHNICAL EFFICACY STAGE: 3.

Abnormal neurite orientation dispersion and density imaging of white matter in children with primary nocturnal enuresis

Several lines of evidence indicate that multiple abnormalities of gray matter are related to the pathogenesis of primary nocturnal enuresis (PNE); however, few studies have been conducted with respect to abnormalities in white matter (WM) of children with PNE. The present work investigated the microstructure of WM in children with PNE using a neurite orientation dispersion and density imaging (NODDI) method. NODDI data were obtained from 29 children with PNE (age = 9.8 ± 1.2 years, 59% males) and 34 healthy controls (age = 10.3 ± 1.6 years, 56% males) in this study. Multi-b-value diffusion-weighted imaging data were acquired with a 3 T MR system, and the orientation dispersion index (ODI) and neurite density index (NDI) maps were calculated. Tract-Based Spatial Statistics analyses of WM tracts were performed with ODI and NDI maps in children with PNE and controls. Children with PNE had lower ODIs in WM fiber tracts of the bilateral superior longitudinal fasciculus (SLF) and higher ODIs in the bilateral internal capsule (IC) and right anterior thalamic radiation (ATR) than controls. PNE children also had lower NDIs in the bilateral IC and the cingulum and higher NDIs in the bilateral SLF. These changes in NODDI indices, which indicated abnormal neural maturation of the WM microstructures, may be related to abnormal sleep and enuresis in children with PNE.

Degree centrality of key brain regions of attention networks in children with primary nocturnal enuresis: A resting-state functional magnetic resonance imaging study

Primary nocturnal enuresis (PNE) is always associated with attention impairment, some of which even could develop to attention deficit hyperactivity disorder. The mechanism of attention impairment is not clear, especially lacking of objective indicators of neuroimaging. The aim of this study is to explore the possible functional imaging mechanism of impaired attention in PNE children. A total of 26 PNE children and 26 age-matched normal controls were recruited. Resting-state functional magnetic resonance imaging (rs-fMRI) was performed on these children. Degree centrality (DC) of key brain regions of DAN (lFEF, rFEF, lIFG, rIFG, lIPS, rIPS), VAN (TPJ, VFC) and DMN (PCC, aMPFC, lAG, rAG) were calculated and compared between PNE and normal children. And the correlations between DC values and attention behavioral results were measured. Compared with normal controls, PNE children exhibited lower DC value in the right frontal eye field (rFEF), left inferior parietal sulcus (lIPS), right inferior parietal sulcus (rIPS), temporal parietal junction (TPJ) and left angular gyrus (lAG). The correct number of continuous performance test (CPT) in the PNE group was significantly lower than the normal controls and there was no significant difference in the reaction time between the two groups. The correlation between DC values and attention behavioral results in PNE showed that the DC values of PCC and lAG were negatively correlated with the correct number. This work indicates that the damage of the key brain regions of DAN, VAN and DMN might be the possible functional imaging mechanism of impaired attention in children with PNE.

Noninvasive imaging of brain oxygen metabolism in children with primary nocturnal enuresis during natural sleep.

A series of studies have revealed that nocturnal enuresis is closely related to hypoxia in children with primary nocturnal enuresis (PNE). However, brain oxygen metabolism of PNE children has not been investigated before. The purpose of this study was to investigate changes in whole-brain cerebral metabolic rate of oxygen (CMRO2 ), cerebral blood flow (CBF), and oxygen extraction fraction (OEF) in children suffering from PNE. We used the newly developed T2-relaxation-under-spin-tagging (TRUST) magnetic resonance imaging technique. Neurological evaluation, structural imaging, phase-contrast, and the TRUST imaging method were applied in children with PNE (n = 37) and healthy age- and sex-matched control volunteers (n = 39) during natural sleep to assess whole-brain CMRO2 , CBF, OEF, and arousal from sleep scores. Results showed that whole-brain CMRO2 and OEF values of PNE children were higher in controls, while there was no significant difference in CBF. Consequently, OEF levels of PNE children were increased to maintain oxygen supply. The elevation of OEF was positively correlated with the difficulty of arousal. Our results provide the first evidence that high oxygen consumption and high OEF values could make PNE children more susceptible to hypoxia, which may induce cumulative arousal deficits and make them more prone to nocturnal enuresis. Hum Brain Mapp 38:2532-2539, 2017. © 2017 Wiley Periodicals, Inc.

Investigation and nursing strategy of illness perceptions in PNE children′s parents

Objective To investigate illness perceptions of primary nocturnal enuresis(PNE) children′s parents, to summarize the nursing countermeasures. Methods A total of 232 children′s parents were evaluated using PNE knowledge questionnaire from November 2011 to November 2014. According to the results, children and parents were cared and educated targetly. Then parents were evaluated again after the treatment and nursing intervention. Results A total of 210 parents completed the evaluation, 95.2% parents knew PNE was a disease, 90.0% parents had correct knowledge of PNE, 91.9% parents clearly knew the inducing factors of PNE, 91.0% parents clearly knew the detriment of PNE, 89.5% parents clearly knew the treatment method of PNE, 94.8% parents knew the recovery of PNE. There were significant differences before and after the nursing intervention (χ2=235.347, 215.872, 207.239, 196.039, 207.499, 216.463, respectively; P<0.05). Conclusions Newly diagnosed PNE children′s parents have a little awareness of the disease, especially lack of the awareness of inducing factors and treatment methods. According to personalcharacter, nursing education can improve the awareness of the disease, and enhance the level of disease control so as to reduce the economic burden on family and society. Key words: Primary nocturnal enuresis; Perceptions; Questionnaires; Children; Nursing

Aberrant Whole-Brain Functional Connectivity and Intelligence Structure in Children with Primary Nocturnal Enuresis

AimTo assess the potential relationship between intelligence structure abnormalities and whole-brain functional connectivity in children with primary nocturnal enuresis (PNE) with resting-state functional magnetic resonance imaging (fMRI) to provide insights into the association between these two seemingly unrelated conditions.MethodsIntelligence testing and fMRI data were obtained from 133 right-handed children, including 67 PNE children (M/F, 39∶28; age, 10.5±1.2 y) and 66 age-matched healthy controls (M/F, 37∶29; age, 10.1±1.1 y). All intelligence tests were performed using the China-Wechsler Intelligence Scale for Children (C-WISC). Each subject’s full intelligence quotient (FIQ), verbal IQ (VIQ), performance IQ (PIQ), and memory/caution (M/C) factor was measured and recorded. Resting state fMRI scans were performed on a 3.0-T MR scanner and post-processed using REST software. Comparisons of z-score correlation coefficients between distinct cerebral regions were used to identify altered functional connectivity in PNE children.ResultsThe PNE group had normal FIQ, VIQ, and PIQ values, indicating no significant variation from the control group. However, the M/C factor was significantly lower in the PNE group. Compared to the control group, PNE children exhibited overall lower levels of functional connectivity that were most apparent in the cerebello-thalamo-frontal pathway. The M/C factor significantly correlated with z-scores representing connectivity between Cerebellum_Crus1_L and Frontal_Mid_R.ConclusionPNE children exhibit intelligence structure imbalance and attention deficits. Our findings suggest that cerebello-thalamo-frontal circuit abnormalities are likely to be involved in the onset and progression of attention impairment in PNE children.

Primary nocturnal enuresis as a risk factor for sleep disorders: an observational questionnaire-based multicenter study

IntroductionPrimary nocturnal enuresis (PNE) is a common problem in developmental age with an estimated overall prevalence ranging from 1.6% to 15%, and possible persistence during adolescence. There is a growing interest in the sleep habits of children affected by PNE, which is derived from the contradictory data present in clinical literature. The aim of the present study was to evaluate the presence of sleep disturbances in a population of children affected by PNE, and to identify whether PNE could be considered as a risk factor for sleep disturbances among children.Materials and methodsA total of 190 PNE children (97 males, 93 females) aged 7–15 years, (mean 9.64 ± 1.35 years), and 766 typically developing children matched for age (P = 0.131) and gender (P = 0.963) were enrolled. To evaluate the presence of sleep habits and disturbances, all of the subjects’ mothers filled out the Sleep Disturbances Scale for Children (SDSC), a questionnaire consisting of six subscales: Disorders in Initiating and Maintaining Sleep (DIMS), Sleep Breathing Disorders (SBD), Disorders of Arousal (DA), Sleep–Wake Transition Disorders (SWTD), Disorders of Excessive Somnolence (DOES), and Nocturnal Hyperhidrosis (SHY). The results were divided into “pathological” and “normal” scores using a cut-off value (pathological score = at least three episodes per week), according to the validation criteria of the test. Then, the Chi-square test was used to calculate the statistical difference and a univariate logistic regression analysis was applied to determine the role of PNE as a risk factor for the development of each category of sleep disorders and to calculate the odds ratio (OR).ResultsPNE children show a higher prevalence of all sleep disturbances (41.03% DIMS; 85.12% SBD; 63.29% DA; 67.53% SWTD; 31.28% DOES; 37.92% SHY; 25.33% SDSC total score), and according to OR results (SDSC total score OR = 8.293, 95% confidence interval [CI] = 5.079–13.540; DIMS OR = 7.639, 95% CI = 5.192–11.238; SBD OR = 35.633, 95% CI = 22.717–55.893; DA OR = 13.734, 95% CI = 9.476–19.906; SWTD OR = 14.238, 95% CI = 9.829–20.625; DOES OR = 5.602, 95% CI = 3.721–8.432; SHY OR = 6.808, 95% CI = 4.608–10.059), PNE could be considered as a risk factor for the development of sleep disorders.ConclusionAmong PNE children, sleep could be strongly altered, thus helping to affirm the hypothesis that PNE tends to alter sleep architecture, or it could itself be the consequence of an abnormal sleep structure. The findings also point to the existence of a potential increase in the risk of developing sleep disorders in the presence of PNE.

Assessment of memory/attention impairment in children with primary nocturnal enuresis: A voxel-based morphometry study

AimAssessment of memory/attention impairment and related exploration of the gray matter differential MR density variations between children with and without primary nocturnal enuresis (PNE) using voxel-based morphometry (VBM) methodology is the aim of the present study. MethodsA total of 75 right-handed PNE children (M/F=39:36, average age 10.4±1.3 years) and 72 age-matched, right-handed, healthy controls (M/F=40:32, 10.0±1.2 years) were recruited for the study. First, intelligence tests were performed using the China-Wechsler Intelligence Scale for Children (C-WISC) in both PNE and control children. The full intelligence quotient (FIQ), verbal IQ (VIQ), performance IQ (PIQ), and memory/caution (M/C) factor were measured. Voxel-based morphometry (VBM) was performed using high resolution 3 Tesla T1-weighted MR images, processed using VBM5 in the PNE and control children. Student's t-test or Mann–Whitney U test were performed to analyze the difference in the gray matter density (GMD) between the PNE and control children. ResultsThe FIQ, VIQ, and PIQ in the PNE group were within the normal range and did not significantly differ from the control group, though the M/C factor was statistically lower in the PNE group. Compared with normal controls, PNE children exhibited lower GMD in the right dorsolateral prefrontal cortex (DLPFC) and the left cerebellum (P<0.001). ConclusionImpairment in memory/attention was detected in PNE children, and the structural abnormalities of the right DLPFC and left cerebellum are likely to be implicated in these deficits.

Evaluation of working memory impairment in children with primary nocturnal enuresis: Evidence from event‐related functional magnetic resonance imaging

To assess the working memory and explore the differential activations of brain areas in children with primary nocturnal enuresis (PNE) by performing functional magnetic resonance imaging (fMRI) scans using the categorical N-Back task. Thirteen right-handed PNE children (M/F = 7:6, average age 11.4 ± 0.8 years) and 15 age-matched, right-handed, healthy controls (M/F = 9:6, 11.3 ± 1.0 years) were recruited for the study. First, intelligence tests were performed using Chinese Wechsler Young Children Scales of Intelligence in PNE children and controls. The full intelligence quotient (FIQ), verbal IQ (VIQ), performance IQ (PIQ) and memory/caution (M/C) factor were measured. After intelligence tests, event-related fMRI scans were performed using the categorical N-Back working memory task on a 3.0T MR scanner. The percent of correct responses (PCR) and the mean reaction time to correct response (mRT) were recorded and compared; fMRI data were analysed using SPM2, the differences in activation were compared with the single subject and between-group levels. The FIQ, VIQ and PIQ in the PNE group were within the normal range and did not significantly differ from the control group (P > 0.05). The M/C factor was statistically significantly lower in the PNE group (P < 0.05). In the N-Back test, PNE children had lower PCR and longer mRT than controls (P < 0.05). A between-group analysis of fMRI data revealed significant attenuation in the left posterior cerebellar lobes of PNE children. PNE children had deficits in working memory, and dysfunction in the left cerebella might be associated with their working memory deficits.

An event-related functional MRI study on working memory impairment in children with primary nocturnal enuresis

Objective To assess the working memory and explore the activation of brain areas for children with primary nocturnal enuresis (PNE) with fMRI scan. Methods Twenty three right-handed children with PNE and 20 age-matched right-handed healthy children as the controls were recruited.Intelligence tests were performed by means of Wechsler Young Children Scales of Intelligence (C-WISC) in children with PNE and normal controls. The full intelligence quotient (FIQ), verbal IQ (VIQ),performances IQ (PIQ) and the memory/caution (M/C) factor of PNE children and the controls were measured. After Intelligence tests, an enent-related fMRI scan was performed using the categorial N-Back working memory task. Percent of correct responses (PCR) and mean reaction time to correct response (mRT) were recorded and analyzed by the student t test. The fMRI data were analyzed using Statistical Parametric Mapping 2 (SPM2), the differences in activation were compared between two groups. Results The data of 15 PNE children and 15 healthy children were evaluated. The FIQ, VIQ and PIQ in PNE group were in a normal range and no statistical significance with the control group ( P ＞ 0. 05). M/C factor in the PNE group(90.4 ±10.2)was significantly lower than that in the control group (99. 6 ± 11.9) (t =2. 260,P ＜ 0. 05). In the N-Back test, PNE children had significantly less PCR [(72.7±6.3 ) % vs. ( 86. 3 ±6. 7) %, t = 5. 727,P ＜ 0. 01] and longer mRT [ (625. 8 ± 72.5) ms vs. (534. 8 ± 63. 3 ) ms, t = 3. 684,P ＜ 0.01] than the healthy controls. The activation regions of PNE patients and healthy children were mainly in the dorsal right frontal lobe, right parietal lobe, left temporal lobe gyrus fusiformis and bilateral cerebellum posterior lobe. The activation level in left posterior cerebellar lobe in PNE children was significant lower than that in healthy controls (P＜0.01). Conclusion The children with PNE have deficits in working memory which might be associated with the dysfunction of the left cerebellum. Key words: Nocturnal enuresis; Magnetic resonance imaging; Memory disorders

Family and segregation studies: 411 Chinese children with primary nocturnal enuresis

The aim of the present paper was to determine the incidence of primary nocturnal enuresis (PNE) among relatives of Chinese children with PNE, the inheritance pattern, and to identify the characteristics of PNE with positive family history. From July 2003 to June 2004, an epidemiological survey on PNE children was carried out by self-administered questionnaires to parents of 5-18-year-old Chinese students in Henan Province, central China. A detailed family history was recorded in order to determine the presence of familial PNE as defined as any close relative with PNE beyond the age of 5 years. The response rate was 88% (10 383/11 799), and 411 children (235 boys and 176 girls) with PNE were identified. A positive family history was found in 94 families (22.87%) of 411 probands with PNE, including 48.94% of fathers, 8.51% of mothers, 6.38% of both parents, 6.38% of the siblings and 29.79% of grandfathers or (and) mothers. Among the probands the ratio of male to female was 1.3:1 excluding sex-linked inheritance. Autosomal dominant inheritance was in 14.60%, and autosomal recessive inheritance was consistent in 1.46% of families. In PNE children with positive family history, the proportion of adolescents, with associated daytime symptoms, marked PNE and seeking professional help were significantly higher than those in PNE children without positive family history. PNE has a significant family clustering, and all modes of inheritance can occur in different families on the basis of a formal genetic analysis. Those with positive family history often manifest marked PNE, and have daytime symptoms.

An Epidemiological Study of Primary Nocturnal Enuresis in Chinese Children and Adolescents

AimsAssessment of the prevalence of primary nocturnal enuresis (PNE) and its risk factors in Chinese children and adolescents in the central areas of mainland China. MethodsA cross-sectional study of PNE was performed by distributing 11799 self-administered questionnaires to parents of 5–18-year-old students in 32 schools of Henan province China. The questionnaire asked about sociodemographic data, PNE data, physical or psychological disorders, and family stressors. The PNE children were divided into a pediatric group (age 5–12) and an adolescent group (age 13–18). ResultsThe response rate was 88% (10383/11799) in which 10088 (85.5%) were qualified to enter the final statistical analysis. The overall prevalence of PNE was 4.07% (95%CI 3.68–4.46) and that of marked PNE was 1.46% (95%CI 1.23–1.69). PNE was significantly more in boys than in girls. The prevalence decreased with age without gender bias. Of all enuretic children, 21.17% had daytime urinary symptoms and 22.87% had a positive family history. Only 6.08% of PNE had sought professional help. The episodic severity of PNE, associated daytime symptoms, positive family history, and seeking for professional help in adolescent group were significantly higher than those of pediatric group. Age, inhabitation (living in rural or urban areas), arousal dysfunction, associated daytime symptoms and family history were found to be significant predictors of marked PNE. Among PNE cases with a positive family history, there was no significant difference in the familial distribution between boys and girls. ConclusionsThe prevalence of age-related PNE from Chinese school children is lower than those reported from western countries and other Asian countries. Age, inhabitation (rural or urban), arousal dysfunction, associated daytime symptom and family history are significant as predictors of marked PNE. The misconceptions among Chinese parents require health education intervention.