The role of the central nervous system (CNS) in overactive bladder (OAB) is not completely understood. Our aim was to investigate the association between alterations in the brain perivascular network and OAB, and to identify potential biomarkers for future intervention trials.
This prospective study included 131 patients with OAB and 119 healthy individuals matched for age, sex, and education. High-resolution 3.0-T magnetic resonance imaging was used to measure brain glymphatic system (BGS) markers, including white matter (WM) and subcortical perivascular space (PVS) characteristics, the free water (FW) fraction, the Analysis Along the Perivascular Space index, and the choroid plexus volume. Spearman and partial correlation analyses were used to examine relationships between imaging results and clinical data. Linear regression and partial correlation analyses for 6-mo follow-up data were conducted to assess longitudinal associations between changes in BGS parameters and OAB symptom progression.
Patients with OAB exhibited notable BGS alterations, among which the WM-PVS count and FW fraction were strongly associated with clinical questionnaire scores. At 6-mo follow-up, progression of OAB symptoms was linked to a significant increase in brain FW content. However, we did not systematically evaluate how bladder function is related to changes in specific brain regions.
This study reveals for the first time an association between BGS dysfunction and OAB symptom severity. Our findings reinforce the role of the CNS in contributing to OAB and highlight potential therapeutic targets.
We used MRI (magnetic resonance imaging) brain scans and questionnaires on overactive bladder (OAB) symptoms to look at possible links between brain changes and OAB. Our results suggest that changes within the brain network may be a central mechanism in OAB. This new discovery may help in the development of new treatments for patients with OAB.
European urology open science. 2025 Dec 04*** epublish ***
Ye Hua, Yuwei Zhang, Feng Lu, Yuhua Zhou, Huihui Song, Deshui Yu, Kaixin Zhang, Qian Liu, Kaiyuan Gu, Tianyi Zhu, Siyi Fu, Yong-Jie Lu, Yi Fan, Ninghan Feng
Department of Urology, Department of Neurology, Department of Imaging, Physical Examination Center, Jiangnan University Medical Center, Wuxi, China., Wuxi School of Medicine, Jiangnan University, Wuxi, China., Centre for Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University, London, UK., Department of Pharmacology, Nanjing Medical University, Nanjing, China.