High spatial correlation in brain connectivity between micturition and resting states within bladder-related networks using 7 T MRI in multiple sclerosis women with voiding dysfunction - Report - MDSpire
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High spatial correlation in brain connectivity between micturition and resting states within bladder-related networks using 7 T MRI in multiple sclerosis women with voiding dysfunction
Brain Connectivity Patterns During Micturition in Women with MS and Voiding Dysfunction
Overview
This study investigated functional connectivity (FC) in bladder-related brain networks during different phases of the bladder cycle in female MS patients with voiding dysfunction using ultra-high field 7 T and 3 T fMRI combined with urodynamics. Significant differences in FC patterns were observed between resting state and bladder states such as strong desire to void and voiding initiation, highlighting altered brain-bladder communication in this population.
Background
Multiple sclerosis (MS) frequently causes neurogenic lower urinary tract dysfunction (NLUTD), with up to 90% of patients experiencing voiding dysfunction or incontinence. Functional MRI (fMRI) enables noninvasive assessment of brain activity and connectivity during bladder filling and voiding. Ultra-high field (7 T) MRI offers enhanced spatial resolution and signal-to-noise ratio, improving detection of subtle brain network changes. Understanding brain connectivity alterations during bladder states in MS patients may inform targeted therapies for voiding dysfunction.
Data Highlights
Parameter
Value/Description
Subjects included
9 female MS patients with voiding dysfunction
Bladder filling rate
50 mL/min sterile water
fMRI field strengths
7 T (7 subjects), 3 T (2 subjects)
Regions of interest (ROIs)
13 bladder-related brain regions
fMRI acquisition parameters (7 T)
TR=2500 ms, TE=24 ms, 1.4 mm isotropic, 8 min resting-state scan
fMRI acquisition parameters (3 T)
TR=2000 ms, TE=30 ms, 2.98 mm isotropic, 7 min resting-state scan
Urodynamic criteria for voiding dysfunction
Post-void residual ≥40% bladder capacity or uroflow below 10th percentile
Key Findings
Functional connectivity patterns differed significantly between resting state and bladder states (strong desire to void, voiding initiation, continued voiding) in bladder-related brain networks.
Ultra-high field 7 T MRI provided high-resolution detection of brain activation changes during bladder filling and voiding phases.
Simultaneous urodynamics and fMRI allowed correlation of bladder physiological states with brain connectivity alterations.
Altered brain-bladder network connectivity may underlie voiding dysfunction in female MS patients.
Noninvasive resting-state FC analysis could potentially serve as a biomarker for bladder dysfunction severity and treatment response.
Clinical Implications
These findings suggest that brain connectivity alterations during bladder filling and voiding contribute to voiding dysfunction in MS patients. Utilizing ultra-high field fMRI combined with urodynamics may improve understanding of neurogenic bladder pathophysiology and guide personalized interventions. Noninvasive imaging biomarkers could aid in monitoring disease progression and therapeutic efficacy in NLUTD.
Conclusion
The study demonstrates distinct functional connectivity changes in bladder-related brain networks during micturition phases in female MS patients with voiding dysfunction, highlighting the potential of advanced neuroimaging to elucidate neural mechanisms underlying neurogenic bladder disorders.
References
Multiple sources cited in study context (e.g., [1-16])
