Brain activation patterns of female multiple sclerosis patients with voiding dysfunction

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


AIMS: We compared brain activation patterns between female multiple sclerosis (MS) patients with voiding dysfunction (VD) and those without. We aim to expand current knowledge of supraspinal correlates of voiding initiation within a cohort of female MS patients with and without VD.

MATERIALS AND METHODS: Twenty-eight ambulatory female MS patients with stable disease and lower urinary tract dysfunction were recruited for this study. Subjects were divided into group 1, without VD (n = 14), and group 2, with VD (n = 14), defined as postvoid residual urine of ≥40% of maximum cystometric capacity or need for self-catheterization. We recorded brain activity via functional magnetic resonance imaging (fMRI) with simultaneous urodynamic testing. Average fMRI activation maps (the Student t test) were created for both groups, and areas of significant activation were identified (P < .05). A priori regions of interest (ROIs), identified by prior meta-analysis to be involved in voiding, were selected.

RESULTS: Group-averaged blood-oxygen level-dependent (BOLD) activation maps demonstrated significant differences between groups 1 and 2 during initiation of voiding with group 2 showing significantly lower levels of activation in all ROIs except for the left cerebellum and right cingulate gyrus. Interestingly, group 2 displayed negative BOLD signals, while group 1 displayed positive signals in the right and left pontine micturition center, right periaqueductal gray, left thalamus, and left cingulate gyrus. The activation map of group 1 was similar to healthy controls.

CONCLUSIONS: Our results support the hypothesis that distinct supraspinal activation patterns exist between female MS patients with VD and those without.

Original languageEnglish (US)
Pages (from-to)969-977
Number of pages9
JournalNeurourology and Urodynamics
Issue number3
StatePublished - Mar 1 2020


  • bladder
  • fMRI
  • incontinence
  • multiple sclerosis
  • urgency
  • Lower Urinary Tract Symptoms/etiology
  • Humans
  • Middle Aged
  • Pons/diagnostic imaging
  • Magnetic Resonance Imaging/methods
  • Cerebellum/diagnostic imaging
  • Thalamus/diagnostic imaging
  • Case-Control Studies
  • Brain/diagnostic imaging
  • Urination Disorders/etiology
  • Gyrus Cinguli/diagnostic imaging
  • Urination/physiology
  • Aged, 80 and over
  • Adult
  • Female
  • Urodynamics/physiology
  • Urinary Bladder/physiopathology
  • Periaqueductal Gray/diagnostic imaging
  • Multiple Sclerosis/complications
  • Functional Neuroimaging
  • Urinary Bladder, Neurogenic/etiology
  • Aged

ASJC Scopus subject areas

  • Clinical Neurology
  • Urology


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