Aim We assessed the impact of cerebral white matter lesions (WMLs) on lower urinary tract symptoms in subjects with normal neurological and cognitive function. Methods A cohort of community-dwelling subjects aged ≥65 years were recruited to undergo MRI brain assessment. WMLs were graded using the Fazekas scale from 0 to 3. A separate telephone interview was carried out to assess the urinary symptoms in these subjects using the questionnaire Overactive Bladder-Validated 8-Question Awareness Tool (OAB-V8). Results 800 community-dwelling elderly subjects were recruited to undergo MRI brain. In this cohort, 431 subjects responded to the telephone interview concerning their urinary symptoms. Among the respondents, 21.1% did not exhibit any WML on their MRI brain. Most of the subjects (52.6%) exhibited grade 1 WML. On logistic regression, age was found to be positively correlated with the Fazekas score (correlation coefficient 0.203, p ≤ 0.01). Using a cutoff of 8 on OAB-V8, 22% of the respondents experienced OAB. Presence of WML, hypertension, or diabetes mellitus was not found to be correlated with storage urinary symptoms or OAB-V8 total score. Multiple logistic regression analysis did not show the presence of WML to be associated with the diagnosis of OAB (adjusted OR 1.13, 95% CI 0.65–1.96, p=0.659). Conclusions WML is associated with age and is common in the elderly population. Mild WML is subclinical, with no obvious neurological and urinary symptoms. Our cohort did not demonstrate a relationship between WML and lower urinary tract symptoms.

Parkinsons's disease (PD) is a chronic neurodegenerative disorder characterized by the loss of dopaminergic neurons of substantia nigra pars compacta in the ventral midbrain.1)The loss of dopaminergic neurons leads to the reduction of dopamine release into the striatum, and is responsible for the clinical features of PD including bradykinesia, resting tremor, rigidity, and difficulty in initiating movements. 2)Pathological patterns of PD are usually examined by inducing Parkinson's like symptoms in rodents by injection of the dopaminergic neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and is widely used for study of PD. 3)MPTP is converted to MPP ϩ , which structurally resembles dopamine, by brain monoamine oxidase B (MAO-B) and can be actively transported into the dopaminergic nerve terminals of the striatum by dopamine transporter (DAT).4) It is important to note that DAT is found only in dopaminergic neurons and may be the best and only unique marker for dopaminergic neurons.5) It has been shown that administration of MPP ϩ alone decreases dopamine transporter protein expression by Western blot. 6) In addition, MPTP intoxication has been reported to be associated with reduced immunoreactivity of tyrosine hydroxylase (TH), the rate-limiting enzyme of dopamine synthesis, 7) in the dopaminergic neurons of substantia nigra via the dopamine uptake system. This is considered to lead to energy failure and subsequently the inhibition of protein expression.8) The reduction of TH-positive neurons is also considered to be a good marker for dopaminergic cell loss.Current therapy for PD is essentially symptomatic, with the use of levodopa, the direct precursor of dopamine, remaining the primary treatment choice since its first use over 30 years ago.9-11) However, long-term therapy with levodopa is associated with significant side effects.12) Neuroprotective therapy to rescue dopamine neurons, which could alter and prevent the progression of PD, 13) has thus been proposed as an alternative to symptomatic treatment. It has been shown that neuroprotection can be observed in the PD models with iron chelators, radical scavenger antioxidants, MAO-B inhibitors, nitric oxide synthase inhibitors, calcium channel antagonists, glutamate antagonist trophic factors.12) Even nicotine and low exposure to cigarette smoke may have a neuroprotective effect on the dopaminergic nigrostriatal system. 14)In addition, epidemiological data suggest that steroid hormone 17b-estradiol plays an important role in protecting the brain from neurodegenerative processes, including Parkinson's disease. Estrogen, but not androgen, has been reported to prevent MPTP-induced dopamine depletion, 15) decrease of DAT mRNA and DAT specific binding.16) Phytoestrogens 6,17) and Chinese medicines, 18) as well as acupuncturing without the use of any drug 19) have also been demonstrated to have neuroprotective effects in PD. As a well-known gynaecological tonic in China, Bak Foong Pill (BFP, China registration #Z980035, also known as Bai Feng Wan) has ...