Bladder and urodynamic changes in multiple sclerosis

Torad, Hesham; Shalaby, Nevin; Hussein, Hussein Aly; Sadek, Samih; Abdel-Azim, Mohamed; Ahmed, Yehia; Morsy, Salem; Soliman, Shaimaa H.

doi:10.1186/s41983-020-00178-z

Cited by 7 publications

(2 citation statements)

References 21 publications

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“…In Iran, the prevalence of MS is 88 per 100,000 population, which indicates the high risk of this disease in this area [ 2 ]. Pelvic floor muscle (PFM) dysfunctions and urinary disorders are the most important motor disorders in patients with MS, which strongly affect their quality of life (QOL) [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Concurrent multi-session anodal trans-cranial direct current stimulation enhances pelvic floor muscle training effectiveness for female patients with multiple sclerosis suffering from urinary incontinence and pelvic floor dysfunction: a randomized clinical trial study

et al. 2023

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Introduction and hypothesis Urinary incontinence following a pelvic floor muscle (PFM) dysfunction is a common disorder in women with multiple sclerosis (MS). Concurrent anodal transcranial direct current stimulation (a-tDCS) of the primary motor cortex (M1) may prime the effects of PFM training (PFMT) in MS patients. This study was aimed at investigating the effects of M1 a-tDCS on the effectiveness of PFMT in the treatment of female MS patients with urinary incontinence and PFM dysfunctions. Methods In a randomized double-blinded, control trial study, 30 women with MS were divided into two groups (experimental group: concurrent active M1 a-tDCS and PFMT; control group: concurrent sham M1 a-tDCS and PFMT). Over the course of 8 weeks, these patients received 20-min interventions three times a week. As an indication of PFM function, the bladder base displacement was measured by ultrasonography before, during the 4th week, immediately, and 1 month after the intervention ended. Urinary incontinence was also measured by Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UISF) before, immediately, and 1 month after the intervention ended. Results A significant improvement in PFM function occurred in the 4th week of intervention and remained 1 month after the intervention in the experimental group when compared with the control group ( p <0.05). Compared with baseline, both groups reported significant improvements in PFM function at 8 weeks ( p <0.05). Also, both groups were found to have decreased ICIQ-UIS scores after the intervention and at 1-month follow-up ( p <0.05). Conclusions In MS patients, M1 a-tDCS can significantly enhance the effects of PFMT on the PFM function and urinary incontinence. Supplementary information The online version contains supplementary material available at 10.1007/s00192-022-05429-6

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Section: Introductionmentioning

confidence: 99%

Concurrent multi-session anodal trans-cranial direct current stimulation enhances pelvic floor muscle training effectiveness for female patients with multiple sclerosis suffering from urinary incontinence and pelvic floor dysfunction: a randomized clinical trial study

et al. 2023

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“…MS lesions are driven by inflammation, OL injury, autoimmunity, myelin breakdown, reactive glial responses (i.e., microgliosis and astrogliosis), and neurodegeneration (Franklin, 2002; Kuhlmann et al, 2008; Popescu et al, 2013). Since the lesions develop randomly, depending on the location of these lesions, MS symptoms widely vary in type, severity, and duration in different patients (Aharony et al, 2017; Araki et al, 2003; Haider et al, 2014; Torad et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Cuprizone‐mediated demyelination reversibly degrades voiding behavior in mice while sparing brainstem reflex

Ramasamy

Hardy

Crocker

et al. 2022

J of Neuroscience Research

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Multiple sclerosis (MS) is a chronic, progressively debilitating demyelinating disease of the central nervous system (CNS). Nearly 80% of MS patients experience lower urinary tract dysfunction early in their diagnosis. This significantly affects the quality of life, and in latter stages of disease is a leading cause of hospitalization. Previously, animal models have shown that inflammatory demyelination in the CNS causes profound bladder dysfunction, but the confounding influence of systemic inflammation limits the potential interpretation of the contribution of CNS demyelination to bladder dysfunction. Since the micturition circuit has myelinated neuronal connections in the cortex, brainstem, and spinal cord, we examined alterations in bladder function in the cuprizone model characterized by demyelinating lesions in the cortex and corpus callosum that are independent of T‐cell–mediated autoimmunity. Herein, we report that a 4‐week dietary cuprizone treatment in C57Bl/6J mice induced alterations in voiding behavior with increased micturition frequency and reduced volume voided, similar to human MS bladder dysfunction. Subsequently, recovery from cuprizone treatment restored normal bladder function. Demyelination and remyelination were confirmed by Luxol Fast Blue staining of the corpus callosum. Additionally, we also determined that an 8‐week cuprizone treatment, resulting in chronic demyelination lacking spontaneous remyelination potential, is associated with an exacerbated voiding phenotype. Interestingly, while cuprizone‐induced CNS demyelination severely affected conscious (cortical) urinary behavior, the brainstem and spinal cord reflex remained unchanged, as confirmed by urethane‐anesthetized cystometry. This is the first study to show that cortical demyelination independent of inflammation can negatively impact urinary function.

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