Overactive bladder (OAB) is a complex condition involving central nervous system (CNS) processes that are not fully understood. We conducted a detailed neuroimaging study to investigate the CNS role in OAB, focusing on the bladder emptying state.
This cross-sectional study included 168 OAB patients and 133 matched controls. Participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI) during the bladder emptying state. Data were analyzed using tract-based spatial statistics (TBSS), graph theory, functional connectivity, and structure-function coupling. The Overactive Bladder Symptom Score (OABSS) and the Overactive Bladder Questionnaire Short Form (OAB-q SF) were also utilized.
TBSS revealed three white matter tracts with higher fractional anisotropy in OAB patients; the largest of these, including the body of the corpus callosum (bCC) and bilateral anterior corona radiata (ACR), correlated positively with OAB-q scores. Functional connectivity analysis indicated increased connectivity between the left dorsolateral superior frontal gyrus (SFGdor.L) and bilateral supplementary motor areas, and reduced connectivity between the left middle temporal gyrus (MTG.L) and the right inferior temporal gyrus (ITG.R). The left amygdala (AMYG.L) exhibited enhanced structure-function coupling, which was positively associated with OABSS and OAB-q scores. However, the study's cross-sectional design precludes determining causal relationships due to the lack of longitudinal data.
This study identified distinct functional and structural brain alterations in OAB patients during the bladder emptying state. These findings offer new perspectives for investigating innovative treatment strategies. Trial registration This study was registered on the UK's Clinical Study Registry (ISRCTN11583354).
European journal of medical research. 2025 Dec 29*** epublish ***
Yangkun Feng, Yuwei Zhang, Ju Zhang, Yifan Sun, Deshui Yu, Huihui Song, Kaixin Zhang, Feng Lu, Xi Liu, Xiuhong Hua, Siyi Fu, Jia Xu, Yi Fan, Jianfeng Shao, Ye Hua
Wuxi School of Medicine, Jiangnan University, Wuxi, China., Department of Urology, Department of Neurology, Department of Imaging, Physical Examination Center, Jiangnan University Medical Center, 68 Zhongshan Road, Wuxi, 214002, China., Wuxi Medical Center, Nanjing Medical University, Wuxi, Jiangsu, China., Department of Pharmacology, Nanjing Medical University, 101 Longmian Road, NanjingNanjing, 211166, China. ., Department of Urology, Department of Neurology, Department of Imaging, Physical Examination Center, Jiangnan University Medical Center, 68 Zhongshan Road, Wuxi, 214002, China. ., Wuxi School of Medicine, Jiangnan University, Wuxi, China. .