Correlation between urinary disorders and imaging changes of cerebral small vessel diseases in community-dwelling populations_West China Medical Journal

Authors：

TANG Mingyu ¹ , SU Ning ¹ , ZHOU Lixin ¹ , YAO Ming ¹ , JIN Zhengyu ² , ZHANG Shuyang ³ , CUI Liying ¹ , ZHU Yicheng ¹ ,  NI Jun ¹

1. Department of Neurology, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, Beijing 100730, P. R. China;
2. Department of Radiology, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, Beijing 100730, P. R. China;
3. Department of Cardiology, Peking Union Medical College Hospital and Chinese Academy of Medical Sciences, Beijing 100730, P. R. China;

Corresponding author：

NI Jun, Email: pumchnijun@163.com

Keywords：

Cerebral small vessel diseases; Urinary disorders; Daytime urination frequency; Brain volume; Cerebral atrophy

DOI：

10.7507/1002-0179.201908156

Video：

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Objective To explore the correlation between urinary disorders and imaging changes of cerebral small vessel diseases (CSVDs) in community-dwelling populations.Methods A cross-sectional analysis was conducted on participants enrolled in the Shunyi study from June 2013 to April 2016. Eligible participants were community-dwelling populations aged ≥35 years with interpretable magnetic resonance imaging scans and no history of stroke or urinary system diseases. Data on demographic characteristics, vascular risk factors, cognitive functions, and urinary disorders (including any form of urinary disorders, incontinence, daytime urination frequency, and nocturnal urination frequency) were collected. Imaging changes including white matter hyperintensities (WMHs), lacunes, cerebral microbleeds (CMBs), perivascular spaces (PVSs), and brain volume were measured using 3 T magnetic resonance imaging. Logistic regression model analysis was performed to identify the potential correlations between urinary disorders and imaging markers of CSVD.Results A total of 916 participants (with a mean age of 57.4 years; 36.2% were males) were finally enrolled in this study based on the enrollment criteria. CSVD imaging changes of WMHs, lacunes, CMBs, PVSs or brain volume were not associated with any form of urinary disorders in multivariable models (P>0.05). CSVD imaging changes were not associated with presence of urinary incontinence (P>0.05). In terms of urinary frequency, the CSVD imaging changes were not related to nocturnal urinary frequency (P>0.05). However, lower brain volume was correlated with daytime urination frequency [3-5 vs. <3 times per day: odds ratio (OR)=2.520, 95% confidence interval (CI) (1.278, 4.972), P=0.008; >5 vs. <3 times per day: OR=3.115, 95%CI (1.317, 7.372), P=0.010].Conclusion Brain atrophy may affect daytime urination frequency in community-dwelling populations.

Citation： TANG Mingyu, SU Ning, ZHOU Lixin, YAO Ming, JIN Zhengyu, ZHANG Shuyang, CUI Liying, ZHU Yicheng, NI Jun. Correlation between urinary disorders and imaging changes of cerebral small vessel diseases in community-dwelling populations. West China Medical Journal, 2019, 34(10): 1109-1116. doi: 10.7507/1002-0179.201908156 Copy

1.	Wardlaw JM, Smith C, Dichgans M. Small vessel disease: mechanisms and clinical implications. Lancet Neurol, 2019, 18(7): 684-696.
2.	de Leeuw FE, de Groot JC, Achten E, et al. Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam Scan Study. J Neurol Neurosurg Psychiatry, 2001, 70(1): 9-14.
3.	Chen X, Wang J, Shan Y, et al. Cerebral small vessel disease: neuroimaging markers and clinical implication. J Neurol, 2018.
4.	de Groat WC, Griffiths D, Yoshimura N. Neural control of the lower urinary tract. Compr Physiol, 2015, 5(1): 327-396.
5.	Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol, 2010, 9(7): 689-701.
6.	Shi Y, Wardlaw JM. Update on cerebral small vessel disease: a dynamic whole-brain disease. Stroke Vasc Neurol, 2016, 1(3): 83-92.
7.	Cannistraro RJ, Badi M, Eidelman BH, et al. CNS small vessel disease: a clinical review. Neurology, 2019, 92(24): 1146-1156.
8.	Inzitari D, Pracucci G, Poggesi AA, et al. Changes in white matter as determinant of global functional decline in older independent outpatients: three year follow-up of LADIS (leukoaraiosis and disability) study cohort. BMJ, 2009, 339: b2477.
9.	Baezner H, Blahak C, Poggesi A, et al. Association of gait and balance disorders with age-related white matter changes. Neurology, 2008, 70(12): 935-942.
10.	O’Brien J, Ames D, Chiu E, et al. Severe deep white matter lesions and outcome in elderly patients with major depressive disorder: follow up study. BMJ, 1998, 317(7164): 982-984.
11.	Poggesi A, Pracucci G, Chabriat HA, et al. Urinary complaints in nondisabled elderly people with age-related white matter changes: the Leukoaraiosis And DISability (LADIS) Study. J Am Geriatr Soc, 2008, 56(9): 1638-1643.
12.	韩菲, 翟菲菲, 周立新, 等. 顺义社区人群无症状性脑梗死的患病率及危险因素. 中华神经科杂志, 2017, 50(7): 515-519.
13.	苏宁. 社区人群脑小血管病相关的脑结构改变与运动功能损伤的相关性研究. 北京: 北京协和医学院, 中国医学科学院, 2018.
14.	Fazekas F, Chawluk JB, Alavi A, et al. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol, 1987, 149(2): 351-356.
15.	张江涛, 陈思禹, 韩菲, 等. 顺义社区人群血管周围间隙发现率及危险因素. 中华医学杂志, 2019, 99(9): 647-652.
16.	Viswanathan A, Godin O, Jouvent E, et al. Impact of MRI markers in subcortical vascular dementia: a multi-modal analysis in CADASIL. Neurobiol Aging, 2010, 31(9): 1629-1636.
17.	Clarkson BD, Griffiths D, Resnick NM. Do brain structural abnormalities differentiate separate forms of urgency urinary incontinence?. Neurourol Urodyn, 2018, 37(8): 2597-2605.
18.	Sakakibara R, Hattori T, Yasuda K, et al. Micturitional disturbance after acute hemispheric stroke: analysis of the lesion site by CT and MRI. J Neurol Sci, 1996, 137(1): 47-56.
19.	Sakakibara R, Hattori T, Uchiyama T, et al. Urinary function in elderly people with and without leukoaraiosis: relation to cognitive and gait function. J Neurol Neurosurg Psychiatry, 1999, 67(5): 658-660.
20.	Tadic S, Griffiths D, Andrew M, et al. Brain activity during bladder filling is related to white matter structural changes in older women with urinary incontinence. Neuroimage, 2010, 51(4): 1294-1302.
21.	Kuchel GA, Moscufo N, Guttmann CR, et al. Localization of brain white matter hyperintensities and urinary incontinence in community-dwelling older adults. J Gerontol A Biol Sci Med Sci, 2009, 64(8): 902-909.
22.	Sakakibara R, Kanda T, Sekido T, et al. Mechanism of bladder dysfunction in idiopathic normal pressure hydrocephalus. Neurourol Urodyn, 2008, 27(6): 507-510.
23.	Sakakibara R, Uchiyama T, Yamanishi TA. Genitourinary dysfunction in Parkinson’s disease. Mov Disord, 2010, 25(1): 2-12.
24.	Sakakibara R, Ito T, Uchiyama T, et al. Lower urinary tract function in dementia of Lewy body type. J Neurol Neurosurg Psychiatry, 2005, 76: 729-732.
25.	Sakakibara R, Panicker J, Fowler CJ, et al. Vascular incontinence: incontinence in the elderly due to ischemic white matter changes. Neurol Int, 2012, 4(2): e13.

1. Wardlaw JM, Smith C, Dichgans M. Small vessel disease: mechanisms and clinical implications. Lancet Neurol, 2019, 18(7): 684-696.
2. de Leeuw FE, de Groot JC, Achten E, et al. Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam Scan Study. J Neurol Neurosurg Psychiatry, 2001, 70(1): 9-14.
3. Chen X, Wang J, Shan Y, et al. Cerebral small vessel disease: neuroimaging markers and clinical implication. J Neurol, 2018.
4. de Groat WC, Griffiths D, Yoshimura N. Neural control of the lower urinary tract. Compr Physiol, 2015, 5(1): 327-396.
5. Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. Lancet Neurol, 2010, 9(7): 689-701.
6. Shi Y, Wardlaw JM. Update on cerebral small vessel disease: a dynamic whole-brain disease. Stroke Vasc Neurol, 2016, 1(3): 83-92.
7. Cannistraro RJ, Badi M, Eidelman BH, et al. CNS small vessel disease: a clinical review. Neurology, 2019, 92(24): 1146-1156.
8. Inzitari D, Pracucci G, Poggesi AA, et al. Changes in white matter as determinant of global functional decline in older independent outpatients: three year follow-up of LADIS (leukoaraiosis and disability) study cohort. BMJ, 2009, 339: b2477.
9. Baezner H, Blahak C, Poggesi A, et al. Association of gait and balance disorders with age-related white matter changes. Neurology, 2008, 70(12): 935-942.
10. O’Brien J, Ames D, Chiu E, et al. Severe deep white matter lesions and outcome in elderly patients with major depressive disorder: follow up study. BMJ, 1998, 317(7164): 982-984.
11. Poggesi A, Pracucci G, Chabriat HA, et al. Urinary complaints in nondisabled elderly people with age-related white matter changes: the Leukoaraiosis And DISability (LADIS) Study. J Am Geriatr Soc, 2008, 56(9): 1638-1643.
12. 韩菲, 翟菲菲, 周立新, 等. 顺义社区人群无症状性脑梗死的患病率及危险因素. 中华神经科杂志, 2017, 50(7): 515-519.
13. 苏宁. 社区人群脑小血管病相关的脑结构改变与运动功能损伤的相关性研究. 北京: 北京协和医学院, 中国医学科学院, 2018.
14. Fazekas F, Chawluk JB, Alavi A, et al. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol, 1987, 149(2): 351-356.
15. 张江涛, 陈思禹, 韩菲, 等. 顺义社区人群血管周围间隙发现率及危险因素. 中华医学杂志, 2019, 99(9): 647-652.
16. Viswanathan A, Godin O, Jouvent E, et al. Impact of MRI markers in subcortical vascular dementia: a multi-modal analysis in CADASIL. Neurobiol Aging, 2010, 31(9): 1629-1636.
17. Clarkson BD, Griffiths D, Resnick NM. Do brain structural abnormalities differentiate separate forms of urgency urinary incontinence?. Neurourol Urodyn, 2018, 37(8): 2597-2605.
18. Sakakibara R, Hattori T, Yasuda K, et al. Micturitional disturbance after acute hemispheric stroke: analysis of the lesion site by CT and MRI. J Neurol Sci, 1996, 137(1): 47-56.
19. Sakakibara R, Hattori T, Uchiyama T, et al. Urinary function in elderly people with and without leukoaraiosis: relation to cognitive and gait function. J Neurol Neurosurg Psychiatry, 1999, 67(5): 658-660.
20. Tadic S, Griffiths D, Andrew M, et al. Brain activity during bladder filling is related to white matter structural changes in older women with urinary incontinence. Neuroimage, 2010, 51(4): 1294-1302.
21. Kuchel GA, Moscufo N, Guttmann CR, et al. Localization of brain white matter hyperintensities and urinary incontinence in community-dwelling older adults. J Gerontol A Biol Sci Med Sci, 2009, 64(8): 902-909.
22. Sakakibara R, Kanda T, Sekido T, et al. Mechanism of bladder dysfunction in idiopathic normal pressure hydrocephalus. Neurourol Urodyn, 2008, 27(6): 507-510.
23. Sakakibara R, Uchiyama T, Yamanishi TA. Genitourinary dysfunction in Parkinson’s disease. Mov Disord, 2010, 25(1): 2-12.
24. Sakakibara R, Ito T, Uchiyama T, et al. Lower urinary tract function in dementia of Lewy body type. J Neurol Neurosurg Psychiatry, 2005, 76: 729-732.
25. Sakakibara R, Panicker J, Fowler CJ, et al. Vascular incontinence: incontinence in the elderly due to ischemic white matter changes. Neurol Int, 2012, 4(2): e13.

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