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What Clinical Parameter Strongly Associates White Matter Tract Alterations in a Multiple Sclerosis Population With Voiding Dysfunction? A Prospective Exploratory Study 什么临床参数能将多发性硬化症患者的白质结构改变与排尿功能障碍紧密联系起来?一项前瞻性探索研究
Pub Date : 2024-01-01 DOI: 10.1097/ju9.0000000000000087
C. Mazeaud, D. Choksi, K. Tran, B. Schott, Yongchang Jang, B. Salazar, C. Karmonik, R. Khavari
To correlate clinical and urodynamics parameters in patients with multiple sclerosis (MS) presenting lower urinary tract symptoms (LUTS) with both Expanded Disability Status Scale (EDSS) and changes in white matter integrity as seen on diffusion tensor images (DTIs). LUTS worsen throughout MS, as does lesion burden. We investigated which symptoms correlated best with structural changes in the white matter structure. Ten adult women >18 years were recruited with stable MS for ≥ 3 months and voiding dysfunction defined as % of post-void residual/bladder volume (%PVR/BV) > 20%. Patients participated in a clinical Urodynamic Study and completed several questionnaires (ie, Hamilton Rating Scale, American Urologic Association Symptom Score, NBS-QoL). DTI images were acquired using a 7-Tesla Siemens MAGNETOM Terra MRI scanner. DTI maps were constructed, and individual patients were coregistered with the International Consortium of Brain Mapping-DTI-81 white matter atlas to extract fractional anisotropy and mean diffusivity (MD). Pearson's correlation test was performed between each white matter tracts (WMT) and clinical parameters and between clinical parameters and the EDSS score as well. P < 0.05 was considered significant. Of the clinical parameters, %PVR/BV obtained from the average of multiple un-instrumented uroflow assessments had significant correlations with the greatest number of WMTs. Furthermore, we observed that in all recorded clinical parameters, %PVR/BV was the only significant parameter correlated with the EDSS score. This study demonstrates that %PVR/BV can be used as an objective parameter to gauge WMT changes and disease progression in patients with MS. Future studies are needed to refine this model.
目的:将出现下尿路症状(LUTS)的多发性硬化症(MS)患者的临床和尿动力学参数与扩展残疾状况量表(EDSS)和弥散张量图像(DTI)上显示的白质完整性变化相关联。在多发性硬化症的整个病程中,尿路症状都会加重,病变负担也会加重。我们研究了哪些症状与白质结构变化最相关。 我们招募了 10 名年龄大于 18 岁的成年女性,她们的多发性硬化症稳定期≥ 3 个月,排尿功能障碍定义为排尿后残余尿量/膀胱容量(%PVR/BV)大于 20%。患者参加了临床尿动力学研究,并完成了几份问卷调查(即汉密尔顿评分量表、美国泌尿协会症状评分、NBS-QoL)。DTI 图像使用 7-Tesla Siemens MAGNETOM Terra MRI 扫描仪采集。绘制了 DTI 图,并将单个患者与国际脑图谱联盟-DTI-81 白质图谱进行核心注册,以提取分数各向异性和平均弥散度(MD)。每个白质束(WMT)与临床参数之间以及临床参数与 EDSS 评分之间进行了皮尔逊相关性检验。P<0.05为差异显著。 在临床参数中,根据多次无仪器尿流评估的平均值得出的百分比PVR/BV与最多的白质束有明显的相关性。此外,我们还观察到,在所有记录的临床参数中,%PVR/BV 是唯一与 EDSS 评分相关的重要参数。 这项研究表明,%PVR/BV 可作为一种客观参数来衡量多发性硬化症患者的 WMT 变化和疾病进展情况。未来的研究还需要完善这一模型。
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引用次数: 1
Reply to Editorial Comment: Microbiomes in Post-DRE Urine Samples Are Linked to Prostate Cancer Risk 回复社论评论:DRE 后尿液样本中的微生物组与前列腺癌风险有关
Pub Date : 2024-01-01 DOI: 10.1097/ju9.0000000000000090
E. D. Crawford, R. Martin, Caleb D. Phillips, Whitney N. Stanton, A. van Bokhoven, M. S. Lucia, Paul Arangua, Francisco G. La Rosa, Zachary Grasmick, Ryan Terlecki, Margaret F. Meagher, Daisaku Hirano, J. C. Nickel, P. Werahera
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引用次数: 0
Editorial Comment: What Clinical Parameter Strongly Associates White Matter Tract Alterations in a Multiple Sclerosis Population with Voiding Dysfunction? A Prospective Pilot Study 社论评论:什么临床参数能将多发性硬化症患者的白质结构改变与排尿功能障碍紧密联系起来?一项前瞻性试点研究
Pub Date : 2024-01-01 DOI: 10.1097/ju9.0000000000000095
Mikołaj Przydacz, Howard B. Goldman
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引用次数: 0
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