Changes in brain white matter structure are associated with urine proteins in urologic chronic pelvic pain syndrome (UCPPS): A MAPP Network study

Abstract

The Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network has yielded neuroimaging and urinary biomarker findings that highlight unique alterations in brain structure and in urinary proteins related to tissue remodeling and vascular structure in patients with Urological Chronic Pelvic Pain Syndrome (UCPPS). We hypothesized that localized changes in diffusion tensor imaging (DTI) measurements might be associated with corresponding changes in urinary protein levels in UCPPS. To test this hypothesis, we created statistical parameter maps depicting the linear correlation between DTI measurements (fractional anisotropy (FA) and apparent diffusion coefficient (ADC)) and urinary protein quantification (MMP2, MMP9, NGAL, MMP9/NGAL complex, and VEGF) in 30 UCPPS patients from the MAPP Research Network, after accounting for clinical covariates. Results identified a brainstem region that showed a strong correlation between both ADC (R2 = 0.49, P<0.0001) and FA (R2 = 0.39, P = 0.0002) with urinary MMP9 levels as well as a correlation between both ADC (R2 = 0.42, P = 0.0001) and FA (R2 = 0.29, P = 0.0020) and urinary MMP9/NGAL complex. Results also identified significant correlations between FA and urinary MMP9 in white matter adjacent to sensorimotor regions (R2 = 0.30, P = 0.002; R2 = 0.36, P = 0.0005, respectively), as well as a correlation in similar sensorimotor regions when examining ADC and urinary MMP2 levels (R2 = 0.42, P<0.0001) as well as FA and urinary MMP9/NGAL complex (R2 = 0.33, P = 0.0008). A large, diffuse cluster of white matter was identified as having a strong correlation between both ADC (R2 = 0.35, P = 0.0006) and FA (R2 = 0.43, P<0.0001) with urinary NGAL levels. In contrast, no significant association between DTI measurements and VEGF was observed. Results suggest that elevated MMP9 or MMP9/NGAL in UCPPS may be related to degenerative neuronal changes in brainstem nuclei through excitotoxicity, while also facilitating synaptic plasticity in sensorimotor regions.

Cognitive behavioral therapy for irritable bowel syndrome induces bidirectional alterations in the brain-gut-microbiome axis associated with gastrointestinal symptom improvement

“…The resulting SPMs were thresholded at a level of significance p <0.05 for each contrast of interest, and a cluster size threshold greater than 250 μL. This minimum cluster size is similar to previous studies using cluster-based permutation correction [ 21 – 23 ], while also trying to maximize the sensitivity to DTI changes.…”

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

“…The inherently unnatural setting of lying supine for fMRI and UDS is a confounding factor that may make it difficult to void for both healthy individuals and especially MS patients who already difficulties voiding. Supine positioning, UDS catheters, and supraphysiologic bladder filling might affect the activation map of different brain regions and subsequently the FC analysis, even though DTI signals in white matter in similar studies have not been found to be altered by these quick dynamic variations [ 33 , 34 ]. Additionally, DTI captures anatomical parameters of the brain, which are not thought to vary as much as FC does [ 35 ].…”

“…Supine positioning, UDS catheters, and supraphysiologic bladder filling might affect the activation map of different brain regions and subsequently the FC analysis, even though DTI signals in white matter in similar studies have not been found to be altered by these quick dynamic variations. [32,33] Additionally, DTI captures anatomical parameters of the brain, which are not thought to vary as much as functional connectivity does. [34] As previously mentioned, our study does not address spinal lesions and the major effects they may have on sensory and motor function.…”

Differential Performance of Neutrophil Gelatinase-Associated Lipocalin and Cystatin C to Predict Ischemic Stroke

“…Inclusion criteria: (a) IS symptoms occur for the rst time, such as limb weakness or numbness, facial numbness or angle of mouth, slurred speech or di culty in understanding language, eyes staring to one side, loss or blurred vision in one or both eyes, dizziness and vomiting, severe headaches that are rare in the past, vomiting, disturbance of consciousness or convulsions. (b) The diagnosis complied with the AHA/ASA "2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke" [19]. The cranial computed tomography examination on admission ruled out the cerebral hemorrhage, but found low-density cortical infarcts or wedge-shaped lacuna edges , band-shaped low-density infarcts, unclear boundary between the basal cortex and surrounding white matter, or the boundary of the lenticular nucleus or even the entire insular lobe structure, without intracranial space-occupying lesions; or the cortex layered punctate or aky high signal (fresh lesions) was found by diffusion-weighted magnetic resonance imaging (DWMRI).…”