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Guillot-Tantay C. Management of lower urinary tract symptoms in Parkinsonian disorders. Rev Neurol (Paris) 2024; 180:101-106. [PMID: 38092575 DOI: 10.1016/j.neurol.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 02/06/2024]
Abstract
INTRODUCTION The aim of the study was to present a narrative review of the literature on the management of lower urinary tract symptoms (LUTS) in patients presenting Parkinsonian disorders (PD). MATERIAL AND METHODS We carried out a literature search in PubMed and Embase database, without time restriction. We used keywords and free-text words around "Parkinsonian disorders" AND "lower urinary tracts symptoms" without language restriction. We focused mainly on papers less than 10 years old. We included all studies evaluating LUTS in patients with PD. RESULTS For the diagnostic management, authors emphasized the importance of differentiating Parkinson's disease with symptoms of bladder overactivity from multiple system atrophy with symptoms of bladder hypoactivity. Urodynamic evaluation was noted as the key element of diagnostic management. The therapeutic management proposed was symptomatic, based on functional urology techniques for the treatment of LUTS, both with drugs (especially anticholinergics) or surgery (intradetrusor injections of botulinum toxin, neuromodulation). Moreover, it was pointed out that it is always necessary to take into account the existence of a possible associated uropathy (prostate adenoma or pelvic prolapse). CONCLUSION Urodynamic evaluation is the cornerstone of diagnostic management of LUTS in patients with PD. Therapeutic management is above all symptomatic and must be done in a collegial way involving the urologist, neurologist, gynecologist, and physical medicine and rehabilitation physician.
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Affiliation(s)
- C Guillot-Tantay
- Service d'urologie, Hôpital Foch, 40, rue Worth, 92150 Suresnes, France.
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Hou M, Mao X, Wei Y, Wang J, Zhang Y, Qi C, Song L, Wan Y, Liu Z, Gan J, Liu Z. Pattern of prefrontal cortical activation and network revealed by task-based and resting-state fNIRS in Parkinson’s disease’s patients with overactive bladder symptoms. Front Neurosci 2023; 17:1142741. [PMID: 37065919 PMCID: PMC10098071 DOI: 10.3389/fnins.2023.1142741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/14/2023] [Indexed: 03/31/2023] Open
Abstract
BackgroundOveractive bladder (OAB) symptoms are common in Parkinson’s disease (PD), and negatively contribute to the quality of life (QoL) of patients. To explore the underlying pathophysiological mechanism, we investigated the correlation between the prefrontal cortex (PFC) function and OAB symptoms in PD patients.MethodsOne hundred fifty-five idiopathic PD patients were recruited and classified either as PD-OAB or PD-NOAB candidates based on their corresponding OAB symptom scores (OABSS). A linear regression analysis identified a correlative connection of cognitive domains. Then cortical activation during the performance of the verbal fluency test (VFT) and brain connectivity during resting state were conducted by functional near-infrared spectroscopy (fNIRS) for 10 patients in each group to investigate their frontal cortical activation and network pattern.ResultsIn cognitive function analysis, a higher OABS score was significantly correlated with a lower FAB score, MoCA total score, and sub-scores of visuospatial/executive, attention, and orientation as well. In the fNIRS study, the PD-OAB group exhibited significant activations in 5 channels over the left hemisphere, 4 over the right hemisphere, and 1 in the median during the VFT process. In contrast, only 1 channel over the right hemisphere showed significant activation in the PD-NOAB group. The PD-OAB group revealed hyperactivation, particularly in certain channel in the left dorsolateral prefrontal cortex (DLPFC), compared with PD-NOAB (FDR P < 0.05). In the resting state, there was a significant increase of the resting state functional connectivity (RSFC) strength between the bilateral Broca area, left frontopolar area (FPA-L) and right Broca’s area (Broca-R), between the FPA and Broca’s area if merging the bilateral regions of interest (ROI), and also between the two hemispheres in the PD-OAB group. The Spearman’s correlation confirmed that the OABS scores were positively correlated with RSFC strength between the bilateral Broca area, FPA-L and Broca-R, between the FPA and Broca area if merging the bilateral ROI.ConclusionIn this PD cohort, OAB was related to decreased PFC functions, with particularly hyperactivated left DLPFC during VTF and an enhanced neural connectivity between the two hemispheres in the resting state as observed by fNIRS imaging.
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Affiliation(s)
- Miaomiao Hou
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaowei Mao
- Department of Neurology, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yarong Wei
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiali Wang
- Department of Neurosurgery, The First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Yu Zhang
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Qi
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lu Song
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Wan
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhihua Liu
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Gan
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Jing Gan,
| | - Zhenguo Liu
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Zhenguo Liu,
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