Altered bladder‐related brain network in multiple sclerosis women with voiding dysfunction

Shi, Zhujun; Karmonik, Christof; Soltes, Amelia M.; Tran, Khue; Lincoln, John A.; Boone, Timothy B.; Khavari, Rose

doi:10.1002/nau.25008

Cited by 6 publications

(2 citation statements)

References 27 publications

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“…They identified differences in functional connectivity within bladder-related brain regions between healthy individuals and MS patients during the "strong desire to void" and "(attempt at) voiding initiation" phases. The findings suggest potential targets for clinical interventions, such as cortical neuromodulation, to address bladder dysfunction in MS patients [20].…”

Section: Exercises and Multiple Sclerosis Kegel And Its Connection To...mentioning

confidence: 91%

Restoring Control: Bladder and Bowel Function Assessment in Multiple Sclerosis Rehabilitation

2023

FEM

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Aims: This study aim was to evaluate the impact of multiple sclerosis on bowel and bladder function and its consequences for socialization and sexual function in MS patients. Additionally, it sought to investigate potential variations in these effects among different MS subtypes. Methodology: A total of 780 participants were internationally recruited, with a predominant representation from the United States. Participants completed self-reported surveys assessing bowel and bladder function, and their MS subtype (relapsing-remitting, primary progressive, or secondary progressive) was documented. Results: Findings indicated that most respondents reported occasional issues with bowel and bladder function. Notably, individuals with primary progressive and secondary progressive MS demonstrated a higher prevalence of bowel and bladder difficulties compared to those with relapsing-remitting MS. Scientific Novelty: This study offers new insights by highlighting the distinct impact of MS subtypes on bowel and bladder function. It underscores the importance of understanding how MS affects various functions of the organism, beyond the central nervous system, and its repercussions for patients' quality of life. Practical Significance of the Results Obtained: The practical significance of this research lies in its potential to inform clinical practice and enhance the QoL for MS patients. Recognizing the unique challenge faced by individuals with primary progressive and secondary progressive MS in terms of bowel and bladder function enables the healthcare providers tailoring interventions and accordingly supporting services. Conclusion: The Multiple sclerosis exerts a multifaceted impact on patients. This study underscored that the type of MS a patient has can significantly affect their bowel and bladder function, potentially leading to difficulties in socialization and sexual function. Acknowledging the study's limitations, including the self-reported data, these findings emphasized the importance of comprehensive care strategies for MS patients.

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Section: Exercises and Multiple Sclerosis Kegel And Its Connection To...mentioning

confidence: 91%

Restoring Control: Bladder and Bowel Function Assessment in Multiple Sclerosis Rehabilitation

2023

FEM

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“…Progressive MS is clinically characterized by a steady decline in neurological function without any periods of recovery ( Lublin and Reingold, 1996 ; Lublin et al, 2014 ) with the potential for eventual paralysis, loss of bowel or bladder control, and blindness ( Lawthom et al, 2003 ; Le Scanff et al, 2008 ; Shi et al, 2022 ). There is now clear evidence that axonal damage/loss is the major determinant of profound neurological deficit in MS affected individuals ( Friese et al, 2014 ).…”

Section: Progressive Ms and Evidence For Molecular Mechanisms Leading...mentioning

confidence: 99%

How does Nogo receptor influence demyelination and remyelination in the context of multiple sclerosis?

Rashidbenam

Öztürk

Pagnin

et al. 2023

Front. Cell. Neurosci.

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Multiple sclerosis (MS) can progress with neurodegeneration as a consequence of chronic inflammatory mechanisms that drive neural cell loss and/or neuroaxonal dystrophy in the central nervous system. Immune-mediated mechanisms can accumulate myelin debris in the disease extracellular milieu during chronic-active demyelination that can limit neurorepair/plasticity and experimental evidence suggests that potentiated removal of myelin debris can promote neurorepair in models of MS. The myelin-associated inhibitory factors (MAIFs) are integral contributors to neurodegenerative processes in models of trauma and experimental MS-like disease that can be targeted to promote neurorepair. This review highlights the molecular and cellular mechanisms that drive neurodegeneration as a consequence of chronic-active inflammation and outlines plausible therapeutic approaches to antagonize the MAIFs during the evolution of neuroinflammatory lesions. Moreover, investigative lines for translation of targeted therapies against these myelin inhibitors are defined with an emphasis on the chief MAIF, Nogo-A, that may demonstrate clinical efficacy of neurorepair during progressive MS.

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Do We Need to Re‐Focus on Functional Female Urethral Disorders in Lower Urinary Tract Dysfunction? ICI‐RS 2024

Chermansky,

Ockrim,

Kheir

et al. 2024

Neurourology and Urodynamics

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AimsInsights into the role of the urethra in maintaining continence and in normal voiding have been provided with advances in imaging techniques. Also, functional urethral testing is used to understand which treatments are optimal for women with functional bladder outlet obstruction (BOO), but which testing is better for which treatment? This review aims to describe our current understanding of female urethral function and dysfunction and to provide future research directions for treating functional female urethral disorders.Materials and MethodsThis is a consensus report of the proceedings of a research proposal discussed at the annual International Consultation on Incontinence‐Research Society (ICI‐RS), 6th–8th June 2024 (Bristol, UK): “Do we need to re‐focus on functional female urethral disorders in lower urinary tract dysfunction? ICI‐RS 2024”.ResultsRegarding female urethral nomenclature, it was agreed that the same terminology should be used in the orientation of the female urethra as in the male. Also, functional MRI and computer modeling could aid further understanding of urethral function in women with voiding dysfunction and OAB symptoms. As for functional urethral assessment, options include video‐urodynamics with leak point pressure (LPP) testing, urethral pressure profilometry (UPP), and striated urethral sphincter electromyography (EMG). Future testing may include the use of modalities (borrowed from cardiologic assessment of vascular structures such as resistive measures obtained with ultrasound) for the purpose of assessing urethral closure. UPP testing has limitations in measurement and reproducibility in assessing urethral pressure. Urethral sphincter EMG is difficult to perform and reproduce. LPP also has limitations related to testing and to patient effort, in addition to being influenced by factors such as bladder volume and compliance. When performing urethral surgery, it is imperative to dissect in tissue planes that preserve urethral function. Regarding therapeutic modalities for the treatment of functional female urethral dysfunction, conservative management includes pelvic floor muscle training with or without biofeedback, electrical stimulation, and extracorporeal magnetic stimulation. Furthermore, there was a robust discussion on the use of cognitive‐behavioral therapy to address psychological comorbidities, thereby improving female LUTD. The evidence supporting long‐term pharmacologic treatment of female urethral LUTD remains scarce. As for invasive management options, the evidence supporting the use of botulinum toxin in female LUTD is limited. Finally, the very existence of BNO and the validity of its diagnosis was discussed. Furthermore, bladder neck incision as a treatment of BNO was debated, and the indications for this procedure include a therapeutic decision balancing benefit to complications.ConclusionImproving the treatment of female functional storage and voiding disorders depends on optimal urethral function assessment. Functional MRI to better understand urethral function, expanding the use of UPP testing, LPP testing, and emerging modalities while maintaining urethral function during female urethral surgery, and addressing psychological comorbidities whilst pursuing both conservative and invasive options (for refractory symptoms) are all important considerations in treating functional female urethral disorders.

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Altered bladder‐related brain network in multiple sclerosis women with voiding dysfunction

Cited by 6 publications

References 27 publications

Restoring Control: Bladder and Bowel Function Assessment in Multiple Sclerosis Rehabilitation

Restoring Control: Bladder and Bowel Function Assessment in Multiple Sclerosis Rehabilitation

How does Nogo receptor influence demyelination and remyelination in the context of multiple sclerosis?

Do We Need to Re‐Focus on Functional Female Urethral Disorders in Lower Urinary Tract Dysfunction? ICI‐RS 2024

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