Are White Matter Tract Integrities Different in Multiple Sclerosis Women With Voiding Dysfunction?

Abstract

Objectives Two white matter tracts (WMTs) are proposed to be involved in bladder function: anterior thalamic radiation and superior longitudinal fasciculus. Multiple sclerosis (MS) patients with voiding dysfunction (VD) may have distinct changes in these 2 WMTs. This study aims to compare the fractional anisotropy (FA) and mean diffusivity (MD) from diffusion tensor imaging of MS females with and without VD versus healthy controls (HCs). Methods Prospective observational cohorts of 28 female MS patients and 11 HCs were recruited. Multiple sclerosis patients were divided into 2 groups: voiders (patients without VD, n = 14) and VD (patients with VD, n = 14). Diffusion tensor imaging of each subject was obtained, from which FA and MD maps were generated. The mean FA and MD of each WMT on both sides were analyzed using one-way analysis of variance and pairwise comparison with adjusted P values. Results Overall MS patients had significantly lower mean FA (loss of coherence) and significantly higher mean MD (increased free diffusion) than HCs in both WMTs, indicating more damage. Furthermore, VD showed a trend of loss of integrity in both WMTs when compared with voiders with lower FA and higher MD. Conclusions There is damage reflected by lower FA and higher MD values in the proposed WMTs involved in bladder function in MS women. Voiding dysfunction in this patient population can be attributed to these damages considering women with VD demonstrated a trend of deterioration in these WMTs compared with women without VD. Future studies with larger sample sizes should be done to further confirm this correlation.

Classification of multiple sclerosis women with voiding dysfunction using machine learning: Is functional connectivity or structural connectivity a better predictor?

“…Due to the demyelinating nature of MS, alternation of grey and white brain matters characteristics and connectivity might present differently in patients who have VD and those who do not. Previous studies have shown differences in both grey and white brain matter in MS patients with NLUTD who have VD compared with those who do not 8,20–22 . In this study, we demonstrate the ability of using ML to both classify and predict development of VD in MS patients using their neuroimaging information.…”

“…VD compared with those who do not. 8,[20][21][22] In this study, we demonstrate the ability of using ML to both classify and predict development of VD in MS patients using their neuroimaging information. In grey matter areas, all MS individuals showed strong connectivity in the frontal brain regions while cerebellar regions exhibited reduced connectivity.…”

“…Meanwhile, SC refers to the white matter tracts physically linking a variety of brain regions 5 . Previous studies have demonstrated both FC and SC are affected in MS patients with NLUTD, where CNS axons are demyelinated and thus disrupt neuronal signal transduction 6–8 . Although the CNS has the innate ability to drive remyelination of disrupted axons, it is only partial, leading to inefficient recovery of function 9,10 .…”

Disruption of specific white matter tracts is associated with neurogenic lower urinary tract dysfunction in women with multiple sclerosis

“…Similarly, the superior longitudinal fasciculus (SLF) was also found to have 8% of the global white matter hyperintensity (WMH) burden and connect to regions activated during bladder filling 10 . Similarly, Tran et al 12 found a lower mean FA and higher mean MD in both the ATR and SLF in MS patients with voiding dysfunction when compared to MS patients without voiding dysfunction.…”

Preliminary Analysis of Brain Footprints in Multiple Sclerosis Females With Detrusor Sphincter Dyssynergia: A Concurrent Urodynamic and Functional Magnetic Resonance Imaging Study

“…[9,10] Dynamic imaging studies, such as positron emission tomography-computed tomography (PET-CT) and functional magnetic resonance imaging (fMRI) modalities, have been implemented to better characterize this complex disease process. [11][12][13] Previously, our team found distinct functional connectivity (FC) patterns using fMRI [13] with more damage in the left anterior thalamic radiation (ATR) on diffusion tensor imaging (DTI) [14] in patients with VD compared to those without. In this study, we aim to assess the grey and white matter of female MS patients with DSD, specifically the FC of brain regions that are activated at the initiation of voiding, and the integrity of two white matter tracts; the ATR and the superior longitudinal fasciculus (SLF), via their fractional anisotropy (FA) and mean diffusivity (MD) values.…”