Presentation Authors: Rose Khavari*, Khue Tran, Christof Karmonik, Saba Elias, Timothy Boone, Houston, TX
Introduction: Many Multiple Sclerosis (MS) patients have Voiding Dysfunction (VD). Since MS lesions mainly affect the white matter, we decided to evaluate the integrity of the two proposed white matter tracts (WMT) involved in proper lower urinary tract (LUT) function: Anterior thalamic radiation (ATR) and the Superior longitudinal fasiculus (FSL). We seek to compare the fractional anisotropy (FA) and mean diffusivity (MD) from the Diffusion Tensor Imaging (DTI) brain scans of female MS patients who are voiders versus patients with VD versus Healthy Control (HC). We hypothesized that MS females with VD have lower FA and higher MD than voiders, and MS patients overall have lower FA and higher MD than HCs in these specific WMTs.
Methods: Twenty-eight female MS patients and eleven HCs were recruited for this study. MS patients were divided into two groups: Group 1; patients without VD (n=15) who void spontaneously and their postvoid residual of urine < 40% Maximum Cystometric Capacity (MCC), and Group 2; patients with VD (n=13) who perform self-catheterization or have postvoid residual of urine â‰¥ 40% MCC. DTI of each subject was obtained, from which FA and MD maps were generated. WMTs were identified based on color FA map, and mean FA and MD of each a priori WMTs on both sides were recorded.
Results: In the two WMTs of interest, mean FA value was lower and mean MD value was higher in Group 2 than Group 1. Both groups had lower mean FA values and higher mean MD values than HCs in the two WMTs. Student t-test indicated that FA was significantly lower and MD was significantly higher in the left ATR of Group 2 than Group 1 (p < 0.05). _x000D_
Interpretation of results: In damaged tissues, FA is lower than normal due to the loss of coherence in the main diffusion direction, and MD is higher than normal as a result of increased free diffusion of the fiber tract. Our results show that there are damages in both regions of interest (ATR and SLF) in MS patients compared to HCs, and provide further evidence to support the importance of these WMTs, especially the left ATR, in proper function of LUT.
Conclusions: Our study shows that there are damages in the two proposed WMTs involved in LUT function in female MS patients and correlates to voiding dysfunction. Assessing the damage of these WMTs, especially the left ATR, may be used as an independent predictive measure for Voiding Dysfunction in MS patients.
Source of Funding: K23DK118209 (NIDDK)