Alteration Of Brainstem Raphe On Transcranial Sonography In Overactive Bladder Patients And The Relationship Between OAB And Affective Symptoms

Objective : To evaluate the alteration of the brainstem raphe(BR)on transcranial sonography(TCS)in overactive bladder(OAB)patients and to investigate the relationship between overactive bladder and depression? Methods :Patients who were diagnosed with OAB and age-matched control subjects without OAB in urology clinic were enrolled.We excluded the subjects with prostate cancer,bladder cancer,history of lower urinary tract surgery,neurogenic bladder,urethral stricture,Parkinson's disease and other serious systemic diseases.A total of 80 patients were picked out in the OAB group and 80 controls in the control group.The degree of OAB were assessed by Overactive Bladder Symptom Severity(OABSS)and were divided into mild,moderate and severe group.The psychological status was evaluated with Self-rating Depression Scale(SDS)and Hamilton Depression Scale(HAMD).Results : Included in the study were 160 cases,including 80 cases in OAB group and 80 cases in non OAB group.(1)The rate of abnormal brainstem raphe(BR)was found to be 67.5%(54/80)in OAB group and 46.3%(37/80)in control patients.The rate of BR was significantly higher(P<0.05)in OAB group than control group.(2)TCS of the raphe in most patients with severe OAB was invisible or interrupted.Most mild OAB patients were found to be normal raphe(63.3%).(3)In OAB patients,lower raphe echogenicity score was associated with higher OABSS scores(P<0.05).(4)According to the Hamilton depression rating scale and depression self-rating scale score,62.5%(50/80)OAB patients in our study had depression,and 43.8%(35/80)in control group.There were significantly differences between the two groups(P<0.05).(5)According to SDS and HAMD,we divided OAB group into OAB+/D+ and OAB+/D-,control group into OAB-/D-and OAB-/D+.Abnormal BR was found much more in OAB+/D+ group than other groups.There were statistically significant difference between the four groups.It indicated that both OAB and depression were associated with abnormal raphe.Conclusion: TCS provides a good tool for assessing OAB and depression.And e found the relationship between OAB and the brainstem raphe on transcranial sonography.