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

Abstract

Objective To identify specific white matter tracts (WMTs) whose disruption is associated with the severity of neurogenic lower urinary tract dysfunction (NLUTD) in two independent cohorts of women with multiple sclerosis (MS) and NLUTD. Methods Cohort 1 consisted of twenty‐eight women with MS and NLUTD. The validation cohort consisted of 10 women with MS and NLUTD. Eleven healthy women served as controls. Participants of both MS cohorts had the same inclusion and exclusion criteria. Both MS cohorts and the healthy controls underwent the same clinical assessment and functional MRI (fMRI) protocol, except that the validation MS cohort underwent 7‐Tesla fMRI scan. Fifteen WMTs (six coursing to relevant brainstem areas) involved in bladder control were a priori regions of interest (ROI). Spearman's correlation test was performed between each the Fractional Anisotropy (FA) and mean diffusivity (MD) of each WMT and the clinical parameters. Results Overall, we found a very high degree of overlap (100% of a priori ROI) in the tracts identified by our correlation analysis as having the greatest contribution to NLUTD symptoms in MS women. The right inferior cerebellar peduncle, left posterior limb of internal capsule, and left superior cerebellar peduncle displayed significant associations to the greatest number of clinical parameters. Conclusions Our correlation analysis supports the role of specific WMT disruptions in the contribution of symptoms in women with MS and NLUTD, as confirmed in two independent MS cohorts.

Evaluating the role of 7-Tesla magnetic resonance imaging in neurosurgery: Trends in literature since clinical approval

“…Subsequent studies should explore and compare the roles of optimized 7T-FLAIR and 7T-MTw imaging[ 44 ]. A recent study aimed to pinpoint white matter tracts (WMTs) associated with the severity of neurogenic lower urinary tract dysfunction (NLUTD) in women with MS[ 45 ]. The primary cohort included 28 women with MS and NLUTD, and a validation cohort comprised 10 women with similar conditions.…”

“…The primary cohort included 28 women with MS and NLUTD, and a validation cohort comprised 10 women with similar conditions. Both cohorts underwent clinical assessments and functional MRI protocols, with the validation cohort additionally undergoing a 7T fMRI scan[ 45 ]. The study identified a robust correlation between fractional anisotropy and mean diffusivity of specific WMTs and clinical parameters related to NLUTD symptoms in women with MS, notably the right inferior cerebellar peduncle, left posterior limb of the internal capsule, and left superior cerebellar peduncle[ 45 ].…”

“…Both cohorts underwent clinical assessments and functional MRI protocols, with the validation cohort additionally undergoing a 7T fMRI scan[ 45 ]. The study identified a robust correlation between fractional anisotropy and mean diffusivity of specific WMTs and clinical parameters related to NLUTD symptoms in women with MS, notably the right inferior cerebellar peduncle, left posterior limb of the internal capsule, and left superior cerebellar peduncle[ 45 ]. Another study aimed to characterize cortical lesions in MS using 7T T2/T1-weighted MRI and assess their relationship with other MS pathology and impact on disability[ 46 ].…”