Urinary dysfunction with detrusor hyperactivity in women with Parkinson's disease cannot be blamed as a factor of worsening motor performance

Campos-Sousa, Raimundo Nonato; Quagliato, Elizabeth Maria Aparecida Barasnevicius; Almeida, Kelson James; Castro, Inácio Augusto Dias de; Campelo, Viriato

doi:10.1590/0004-282x20130101

Cited by 9 publications

(6 citation statements)

References 25 publications

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“…144, 147 Nocturia, frequency, and urgency are the most prevalent bladder symptoms in PD. These symptoms are generally suggestive of detrusor overactivity, which has been corroborated in several urodynamic studies demonstrating detrusor over activity in 40–80% of medicated PD patients, 148–150 and also in 58% of de novo untreated patients. 151 The bladder volume at first desire to void is reduced in PD, 151, 152 but detrusor activity during voiding is actually decreased in 50% of patients.…”

Section: Urodynamic Studiessupporting

confidence: 54%

Imaging Parkinson’s disease below the neck

Borghammer

Knudsen

Fedorova

et al. 2017

npj Parkinson's Disease

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Parkinson’s disease is a systemic disorder with widespread and early α-synuclein pathology in the autonomic and enteric nervous systems, which is present throughout the gastrointestinal canal prior to diagnosis. Gastrointestinal and genitourinary autonomic symptoms often predate clinical diagnosis by several years. It has been hypothesized that progressive α-synuclein aggregation is initiated in hyperbranched, non-myelinated neuron terminals, and may subsequently spread via retrograde axonal transport. This would explain why autonomic nerves are so prone to formation of α-synuclein pathology. However, the hypothesis remains unproven and in vivo imaging methods of peripheral organs may be essential to study this important research field. The loss of sympathetic and parasympathetic nerve terminal function in Parkinson’s disease has been demonstrated using radiotracers such as 123I-meta-iodobenzylguanidin, 18F-dopamine, and 11C-donepezil. Other radiotracer and radiological imaging methods have shown highly prevalent dysfunction of pharyngeal and esophageal motility, gastric emptying, colonic transit time, and anorectal function. Here, we summarize the methodology and main findings of radio-isotope and radiological modalities for imaging peripheral pathology in Parkinson’s disease.

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Section: Urodynamic Studiessupporting

confidence: 54%

Imaging Parkinson’s disease below the neck

Borghammer

Knudsen

Fedorova

et al. 2017

npj Parkinson's Disease

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“…Bladder capacity and volume at first desire to void and urge to void are reduced in PD [20,39]. Detrusor over activity, volume at first desire to void and bladder capacity correlate with disease severity in most studies [14,32,35,38] but not all [37].…”

Section: Urodynamic Findings and Parkinson's Diseasementioning

confidence: 93%

Lower urinary tract symptoms in Parkinson's disease: Prevalence, aetiology and management

McDonald

Winge

Burn

2017

Parkinsonism & Related Disorders

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Lower urinary tract symptoms (LUTS) are common in Parkinson's disease (PD), effecting 27-85% of patients with PD. Irritative symptoms predominate and urodynamic studies confirm high prevalence of detrusor overactivity in PD. LUTS are present early in PD and are more common in PD than in age matched controls. The assessment of LUTS in PD is complicated by coexisting bradykinesia and cognitive impairment. Although LUTS become more troublesome as PD progresses it remains unclear if LUTS severity correlates with motor symptoms and/or duration of PD. The underlying cause of LUTS in PD remains to be fully elucidated. Animal and human studies suggest the net effect of the basal ganglia is to supress micturition. Although LUTS are a common in PD, few studies have examined the assessment and management of LUTS specifically in patients with PD. Pilot studies have suggested that bladder training, antimuscarinic drugs and intravesical botulinum toxin maybe helpful but these trials have been small and frequently lacked a suitable control group making them vulnerable to the placebo effect. Furthermore the adverse effects of antimuscarinic drugs on cognitive and gastrointestinal function may limit the use of these drugs in PD. In this review we summarise the literature describing the prevalence of LUTS in PD, discuss the emerging data delineating the underlying pathophysiology of LUTS and examine interventions helpful in the management of LUTS in people with PD.

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“…This suggests that pollakiuria is related to the severity of disease and mental state, which is consistent with a previous report. [ 26 ]…”

Section: Discussionmentioning

confidence: 99%

Investigation of Urination Disorder in Parkinson's Disease

Zhang

2015

Chinese Medical Journal

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Background:Urination disorders are common in Parkinson's disease (PD) and respond poorly to medication. This study aimed to analyze the risk factors for urination disorders in PD.Methods:Ninety-one patients with PD (aged 34–83 years old) were recruited. Patients were assessed with the Unified PD Rating Scale (UPDRS), Hoehn and Yahr stage, Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Rating Scale (HAMD), and Hamilton Anxiety Scale (HAMA). Micturition number was recorded, and Type B ultrasound was used to evaluate residual urine. Statistics was performed using binary logistic regression, bivariate correlations, and Chi-square and t-tests.Results:Of 91 patients, urinary dysfunction occurred in 55.0%. Among these, 49.5% suffered with nocturia, 47.3% with pollakiuria. Nocturia number had a positive linear relationship with HAMA score (odds ratio [OR] = 0.340, P = 0.001), HAMD score (OR = 0.323, P = 0.002), duration of L-dopa medication (OR = 0.328, P = 0.001), dose of L-dopa (OR = 0.273, P = 0.009), UPDRS-II (OR = 0.402, P = 0.000), UPDRS-III score (OR = 0.291, P = 0.005), and PSQI score (OR = 0.249, P = 0.017). Micturition number over 24 h was positively associated with HAMA (OR = 0.303, P = 0.004) and UPDRS-II scores (OR = 0.306, P = 0.003). Of patients with residual urine, 79.3% had a volume of residual urine <50 ml. Residual urine was present in 44.4% of the patients with nocturia, 46.5% of the patients with pollakiuria, and 80.0% of the patients with dysuria. More men than women had residual urine (35.2% male vs. 13.3% female; P = 0.002).Conclusions:Nocturia and pollakiuria were common micturition symptoms in our participants with PD. Nocturia was associated with depression, anxiety, sleep problems, and severity of PD. Pollakiuria was associated with anxiety and severity of PD. Male patients were more prone to residual urine and pollakiuria.

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Urinary dysfunction with detrusor hyperactivity in women with Parkinson's disease cannot be blamed as a factor of worsening motor performance

Cited by 9 publications

References 25 publications

Imaging Parkinson’s disease below the neck

Imaging Parkinson’s disease below the neck

Lower urinary tract symptoms in Parkinson's disease: Prevalence, aetiology and management

Investigation of Urination Disorder in Parkinson's Disease

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