Transcranial Sonography Image Characteristics In Overactive Bladder Patients

Objectives:Prior studies have demonstrated idiopathic Parkinson's patients with overactive bladder syndrome(OAB)have a specific changes of the brainstem raphe(BR)on transcranial sonography(TCS),however,it is uncertain that whether there are alterations of BR in patients with OAB only.So we performed this study to evaluate the brainstem raphe features on TCS in OAB patients and to explore the relationship between OAB and depression(D).Methods:83 OAB patients and 66 Normal controls(NC)at The Second Affiliated Hospital of Soochow University,between January 2017 and June 2018,were enrolled in this study.OAB patients fulfilled the criteria of the International Continence Society.Healthy volunteers were recruited from the physical examination center of our hospital.Depression was assessed by two physicians according to the scores of self-rating Depression scale(SDS)and Hamilton Depression Scale(HAMD).The alteration of BR were observed by two urologists with more than five years' TCS working experience.The characteristics of TCS(raphe nucleus,substantia nigra,third ventricle,lenticular nucleus)were compared between the two groups,Sonographic alterations and clinical characteristics among the two groups were analyzed.Results:9 subjects(5 OAB,4 NC)were excluded due to poor temporal window,and 4 subjects(2 OAB,2 NC)were excluded for the different TCS results of two sonologists.Totally,76 OAB patients and 60 NC were included in this study.(1)The rate of hypoechogenicity of the BR was higher in the OAB group 80.26%(61/76)than 18.33%(11/60)in NC.There were statistical differences(?2-51.62,P<0.01);(2)According to depression Self-rating scale score and the Hamilton depression rating scale,28.95%(22/76)OAB patients in our study had depression and 5.00%(3/60)in NC.There were significantly differences between the two groups(?2=12.82,P<0.01),which indicated OAB was associated with the occurrence of depression;(3)To verify the relationship between OAB and depression,we divided OAB group into OAB+/D+ and OAB+/D-.We found that the scores of Overactive Bladder Symptom Severity(OABSS)and Urgent micturition(UI)were significantly higher in OAB+/D+group(9.08± 2.36 and 3.08 ± 0.93,respectively)compared with OAB+/D-group(5.58±1.32 and 2.65± 0.68,respectively,P<0.01 and P=0.03,respectively).Conclusion:1.OAB patients are always showed abnormal raphe on TCS;2.Depression is more common on OAB patients;3.OABSS and UI scores are significantly higher in OAB+/D+group compared with OAB+/D-group,it may indicate that depression may increase the severity of OAB.