Lower Urinary Tract Symptoms in Subjects with Subclinical Cerebral White Matter Lesions

Yee, Chi‐Hang; Leung, Ching Cheong; Wong, Yuki Yu-Ting; Lee, Sylvia; Li, Jenny; Kwan, Pauline; Chu, Winnie Chiu-Wing; Mok, Vincent; Ng, Chi‐Fai

doi:10.1155/2018/1582092

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…[ 93 ] As for urinary incontinence, it usually presents at a more advanced stage of the disease. [ 13 , 95 ]…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Pandemic of the aging society — sporadic cerebral small vessel disease

Lau

et al. 2021

Chinese Medical Journal

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Age-related sporadic cerebral small vessel disease (CSVD) has gained increasing attention over the past decades because of its increasing prevalence associated with an aging population. The widespread application of and advances in brain magnetic resonance imaging in recent decades have significantly increased researchers’ understanding in the in vivo evolution of CSVD, its impact upon the brain, its risk factors, and the mechanisms that explain the various clinical manifestation associated with sporadic CSVD. In this review, we aimed to provide an update on the pathophysiology, risk factors, biomarkers, and the determinants and spectrum of the clinical manifestation of sporadic CSVD.

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“…[ 93 ] As for urinary incontinence, it usually presents at a more advanced stage of the disease. [ 13 , 95 ]…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Pandemic of the aging society — sporadic cerebral small vessel disease

Lau

et al. 2021

Chinese Medical Journal

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“…Eight studies, mostly in older community dwelling-subjects, detected urinary symptom associations with WMH (total n = 1944), [ 34 – 41 ] while two did not ( n = 648). [ 42 , 43 ] These findings need to be reproduced in large prospective blinded studies, adjusting for mobility, frailty and co-morbidities.…”

Section: Defining the Natural History Of Clinical Cerebral Small Vessmentioning

confidence: 99%

Clinical management of cerebral small vessel disease: a call for a holistic approach

Clancy

Appleton

Arteaga

et al. 2020

Chinese Medical Journal

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Cerebral small vessel disease (SVD) is a common global brain disease that causes cognitive impairment, ischemic or hemorrhagic stroke, problems with mobility, and neuropsychiatric symptoms. The brain damage, seen as focal white and deep grey matter lesions on brain magnetic resonance imaging (MRI) or computed tomography (CT), typically accumulates “covertly” and may reach an advanced state before being detected incidentally on brain scanning or causing symptoms. Patients have typically presented to different clinical services or been recruited into research focused on one clinical manifestation, perhaps explaining a lack of awareness, until recently, of the full range and complexity of SVD. In this review, we discuss the varied clinical presentations, established and emerging risk factors, relationship to SVD features on MRI or CT, and the current state of knowledge on the effectiveness of a wide range of pharmacological and lifestyle interventions. The core message is that effective assessment and clinical management of patients with SVD, as well as future advances in diagnosis, care, and treatment, will require a more “joined-up”’ approach. This approach should integrate clinical expertise in stroke neurology, cognitive, and physical dysfunctions. It requires more clinical trials in order to improve pharmacological interventions, lifestyle and dietary modifications. A deeper understanding of the pathophysiology of SVD is required to steer the identification of novel interventions. An essential prerequisite to accelerating clinical trials is to improve the consistency, and standardization of clinical, cognitive and neuroimaging endpoints.

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“…White matter abnormalities such as hyperintensities are becoming increasingly more known to be associated with LUTS especially in elderly. (25,26) Two white matter tracts (WMT)s are particularly important in proper function of the bladder: The anterior thalamic radiation (ATR) and superior longitudinal fasciculus (SLF) (27,28). WMT integrity can be evaluated using diffusion tensor imaging and assessing the fractional anisotropy and mean diffusivity of each tract to provide additional meaningful data in evaluation of voiding dysfunction, figure 1.…”

Section: Functional Neuroimaging and Voidingmentioning

confidence: 99%

Functional Brain Imaging in Voiding Dysfunction

Khavari

Boone

2019

Curr Bladder Dysfunct Rep

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Purpose of review: Voiding dysfunction (VD) is morbid, costly, and leads to urinary tract infections, stones, sepsis, and permanent renal failure. Evaluation and diagnosis of VD in nonobstructed patients can be challenging. Potential diagnostic and therapeutic options beyond the bladder, such as brain centers involved in voiding have been proposed as promising targets. This review focuses on current and future applications of functional neuroimaging in human in voiding and in patients with VD. Recent findings: The current understanding of brain centers, and their roles in initiating, maintaining and/or modulating voiding, is rudimentary in humans and in patients with VD. With the advent and advancement in functional neuroimaging we are gaining more insight into specific brain regions involved in the voiding phase of micturition. In healthy individuals, right dorsomedial pontine tegmentum, periaqueductal grey, hypothalamus, and the inferior, medial and superior frontal gyrus have been identified as regions of interest in voiding. Summary: Functional neuroimaging could suggest new diagnostic methods and provides crucial steps towards therapeutic options for the morbid and intractable VD condition, in patients with neurogenic (e.g. MS or Strokes) or non-neurogenic VD (e.g. underactive bladder or Fowler's syndrome).

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Lower Urinary Tract Symptoms in Subjects with Subclinical Cerebral White Matter Lesions

Cited by 6 publications

References 25 publications

Pandemic of the aging society — sporadic cerebral small vessel disease

Pandemic of the aging society — sporadic cerebral small vessel disease

Clinical management of cerebral small vessel disease: a call for a holistic approach

Functional Brain Imaging in Voiding Dysfunction

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