Is there "brain OAB" and how can we recognize it? International Consultation on Incontinence-Research Society (ICI-RS) 2017

Apostolos Apostolidis*, Adrian Wagg, Mohammad S. Rahnama'i, Jalesh N. Panicker, Desiree Vrijens, Alexander von Gontard

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Web of Science)

Abstract

AimsIn light of mounting evidence supporting the association of brain regions with the control of urine storage and voiding, the high placebo effect in OAB studies as well as certain anecdotal observations from clinical practice with OAB patients, the role of the brain in OAB was explored. MethodsAt the ICI-RS 2017 meeting, a panel of Functional Urologists and Basic Scientists presented literature data generating a proposal to discuss whether there is brain OAB and how we could recognize it. ResultsExisting data point toward organic brain causes of OAB, in particular concerning white matter disease (WMD) and aging, but with currently speculative mechanisms. Imaging techniques have revealed connectivity changes between brain regions which may explain brain-peripheral interactions in OAB patients, further to acknowledged structural and functional changes in the central nervous system (CNS). Furthermore, psychological disorders like stress and depression have been identified as causes of OAB, with animal and human studies proposing a neurochemical and neuroendocrine pathophysiological basis, involving either the serotoninergic system or the hypothalamic-pituitary-adrenal axis. Finally, childhood data suggest that OAB could be a developmental disorder involving the CNS, although childhood OAB could be a different condition than that of adults in many children. ConclusionsFuture research should aim to identify the pathogenesis of WMD and the aging processes affecting the brain and the bladder, with possible benefits in prevention strategies, as well as connectivity disorders within the CNS, the pathophysiology of OAB in childhood and the neurochemical pathways connecting affective disorders with OAB.
Original languageEnglish
Pages (from-to)S38-S45
Number of pages8
JournalNeurourology and Urodynamics
Volume37
DOIs
Publication statusPublished - 1 Jun 2018

Keywords

  • aging
  • brain
  • childhood
  • depression
  • incontinence
  • overactive bladder
  • stress
  • DAYTIME URINARY-INCONTINENCE
  • CHILDRENS CONTINENCE SOCIETY
  • OVERACTIVE BLADDER SYNDROME
  • URGE INCONTINENCE
  • WHITE-MATTER
  • NOCTURNAL ENURESIS
  • STANDARDIZATION DOCUMENT
  • SMOOTH-MUSCLE
  • OLDER-ADULTS
  • WOMEN

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