Skip to main content
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 3/2008

01.03.2008 | Original Article

Urinary incontinence and its functional anatomy in frontotemporal lobar degenerations

verfasst von: Robert Perneczky, Janine Diehl-Schmid, Hans Förstl, Alexander Drzezga, Florian May, Alexander Kurz

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 3/2008

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The frontal lobes play a crucial role in micturition control. However, no reports exist on the functional role of distinct frontal brain regions in urinary incontinence (UIC) in patients with a neurodegenerative damage of the frontal lobe. The aim of the present study was therefore to explore if functional brain lesions were associated with UIC in patients suffering from frontotemporal lobar degenerations (FTLD).

Methods

Forty-four patients, including eight incontinent subjects, underwent cranial positron emission tomography scanning with 18F-fluoro-2-deoxy-glucose (18F-FDG PET) to assess the relative metabolic rate of glucose (rCMRglc). Group comparisons of rCMRglc were conducted in SPM2 to identify brain regions where the group of incontinent patients (FTLD+UIC) had significant alterations compared with the group without UIC (FTLD−UIC).

Results

At the stringent statistical threshold of p < 0.05, corrected for multiple comparisons according to the family-wise error rate, the statistical analysis revealed two significant right-hemispheric hypometabolic clusters located in the premotor/anterior cingulate cortex and the putamen/claustrum/insula. No hypermetabolic regions were found.

Conclusions

The present study is the first to provide evidence for brain functional alterations involved in the occurrence of UIC in FTLD. These results provide an important piece of evidence to the understanding of a particularly distressing autonomic nervous system symptom of dementia.
Literatur
1.
Zurück zum Zitat Andrew J, Nathan PW. Lesions on the anterior frontal lobes and disturbances of micturition and defaecation. Brain 1964;87:233–62.PubMedCrossRef Andrew J, Nathan PW. Lesions on the anterior frontal lobes and disturbances of micturition and defaecation. Brain 1964;87:233–62.PubMedCrossRef
2.
Zurück zum Zitat Athwal BS, Berkley KJ, Hussain I, et al. Brain responses to changes in bladder volume and urge to void in healthy men. Brain 2001;124:369–77.PubMedCrossRef Athwal BS, Berkley KJ, Hussain I, et al. Brain responses to changes in bladder volume and urge to void in healthy men. Brain 2001;124:369–77.PubMedCrossRef
3.
Zurück zum Zitat Bennett DA, Gilley DW, Lee S, et al. White matter changes: neurobehavioral manifestations of Binswanger’s disease and clinical correlates in Alzheimer’s disease. Dementia 1994;5:148–52.PubMedCrossRef Bennett DA, Gilley DW, Lee S, et al. White matter changes: neurobehavioral manifestations of Binswanger’s disease and clinical correlates in Alzheimer’s disease. Dementia 1994;5:148–52.PubMedCrossRef
4.
Zurück zum Zitat Blok BF, Willemsen AT, Holstege G. A PET study on brain control of micturition in humans. Brain 1997;120(Pt 1):111–21.PubMedCrossRef Blok BF, Willemsen AT, Holstege G. A PET study on brain control of micturition in humans. Brain 1997;120(Pt 1):111–21.PubMedCrossRef
5.
Zurück zum Zitat Boecker H, Ceballos-Baumann AO, Volk D, et al. Metabolic alterations in patients with Parkinson disease and visual hallucinations. Arch Neurol 2007;64:984–8.PubMedCrossRef Boecker H, Ceballos-Baumann AO, Volk D, et al. Metabolic alterations in patients with Parkinson disease and visual hallucinations. Arch Neurol 2007;64:984–8.PubMedCrossRef
6.
Zurück zum Zitat Bush G, Luu P, Posner MI. Cognitive and emotional influences in anterior cingulate cortex. Trends Cogn Sci 2000;4:215–22.PubMedCrossRef Bush G, Luu P, Posner MI. Cognitive and emotional influences in anterior cingulate cortex. Trends Cogn Sci 2000;4:215–22.PubMedCrossRef
7.
Zurück zum Zitat Critchley HD, Wiens S, Rotshtein P, et al. Neural systems supporting interoceptive awareness. Nat Neurosci 2004;7:189–95.PubMedCrossRef Critchley HD, Wiens S, Rotshtein P, et al. Neural systems supporting interoceptive awareness. Nat Neurosci 2004;7:189–95.PubMedCrossRef
8.
Zurück zum Zitat Diehl-Schmid J, Grimmer T, Drzezga A, et al. Longitudinal changes of cerebral glucose metabolism in semantic dementia. Dement Geriatr Cogn Disord 2006;22:346–51.PubMedCrossRef Diehl-Schmid J, Grimmer T, Drzezga A, et al. Longitudinal changes of cerebral glucose metabolism in semantic dementia. Dement Geriatr Cogn Disord 2006;22:346–51.PubMedCrossRef
9.
Zurück zum Zitat Diehl-Schmid J, Grimmer T, Drzezga A, et al. Decline of cerebral glucose metabolism in frontotemporal dementia: a longitudinal 18F-FDG-PET-study. Neurobiol Aging 2007;28:42–50.PubMedCrossRef Diehl-Schmid J, Grimmer T, Drzezga A, et al. Decline of cerebral glucose metabolism in frontotemporal dementia: a longitudinal 18F-FDG-PET-study. Neurobiol Aging 2007;28:42–50.PubMedCrossRef
10.
Zurück zum Zitat Drzezga A, Lautenschlager N, Siebner H, et al. Cerebral metabolic changes accompanying conversion of mild cognitive impairment into Alzheimer’s disease: a PET follow-up study. Eur J Nucl Med Mol Imaging 2003;30:1104–13.PubMedCrossRef Drzezga A, Lautenschlager N, Siebner H, et al. Cerebral metabolic changes accompanying conversion of mild cognitive impairment into Alzheimer’s disease: a PET follow-up study. Eur J Nucl Med Mol Imaging 2003;30:1104–13.PubMedCrossRef
11.
Zurück zum Zitat Drzezga A, Riemenschneider M, Strassner B, et al. Cerebral glucose metabolism in patients with AD and different APOE genotypes. Neurology 2005;64:102–7.PubMed Drzezga A, Riemenschneider M, Strassner B, et al. Cerebral glucose metabolism in patients with AD and different APOE genotypes. Neurology 2005;64:102–7.PubMed
12.
Zurück zum Zitat Dubois B, Slachevsky A, Litvan I, et al. The FAB: a Frontal Assessment Battery at bedside. Neurology 2000;55:1621–6.PubMed Dubois B, Slachevsky A, Litvan I, et al. The FAB: a Frontal Assessment Battery at bedside. Neurology 2000;55:1621–6.PubMed
13.
Zurück zum Zitat Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–98.PubMedCrossRef Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–98.PubMedCrossRef
14.
Zurück zum Zitat Gorno-Tempini ML, Dronkers NF, Rankin KP, et al. Cognition and anatomy in three variants of primary progressive aphasia. Ann Neurol 2004;55:335–46.PubMedCrossRef Gorno-Tempini ML, Dronkers NF, Rankin KP, et al. Cognition and anatomy in three variants of primary progressive aphasia. Ann Neurol 2004;55:335–46.PubMedCrossRef
15.
Zurück zum Zitat Griffiths D. Clinical studies of cerebral and urinary tract function in elderly people with urinary incontinence. Behav Brain Res 1998;92:151–5.PubMedCrossRef Griffiths D. Clinical studies of cerebral and urinary tract function in elderly people with urinary incontinence. Behav Brain Res 1998;92:151–5.PubMedCrossRef
16.
Zurück zum Zitat Griffiths D, Tadic SD, Schaefer W, et al. Cerebral control of the bladder in normal and urge-incontinent women. Neuroimage 2007;37:1–7.PubMedCrossRef Griffiths D, Tadic SD, Schaefer W, et al. Cerebral control of the bladder in normal and urge-incontinent women. Neuroimage 2007;37:1–7.PubMedCrossRef
17.
Zurück zum Zitat Harvey RJ, Skelton-Robinson M, Rossor MN. The prevalence and causes of dementia in people under the age of 65 years. J Neurol Neurosurg Psychiatry 2003;74:1206–9.PubMedCrossRef Harvey RJ, Skelton-Robinson M, Rossor MN. The prevalence and causes of dementia in people under the age of 65 years. J Neurol Neurosurg Psychiatry 2003;74:1206–9.PubMedCrossRef
18.
Zurück zum Zitat Herholz K, Salmon E, Perani D, et al. Discrimination between Alzheimer dementia and controls by automated analysis of multicenter FDG PET. Neuroimage 2002;17:302–16.PubMedCrossRef Herholz K, Salmon E, Perani D, et al. Discrimination between Alzheimer dementia and controls by automated analysis of multicenter FDG PET. Neuroimage 2002;17:302–16.PubMedCrossRef
19.
Zurück zum Zitat Hirono N, Kitagaki H, Kazui H, et al. Impact of white matter changes on clinical manifestation of Alzheimer's disease: a quantitative study. Stroke 2000;31:2182–8.PubMed Hirono N, Kitagaki H, Kazui H, et al. Impact of white matter changes on clinical manifestation of Alzheimer's disease: a quantitative study. Stroke 2000;31:2182–8.PubMed
20.
Zurück zum Zitat Holstege G, Griffiths D, de Wall H, et al. Anatomical and physiological observations on supraspinal control of bladder and urethral sphincter muscles in the cat. J Comp Neurol 1986;250:449–61.PubMedCrossRef Holstege G, Griffiths D, de Wall H, et al. Anatomical and physiological observations on supraspinal control of bladder and urethral sphincter muscles in the cat. J Comp Neurol 1986;250:449–61.PubMedCrossRef
21.
Zurück zum Zitat Hughes CP, Berg L, Danziger WL, et al. A new clinical scale for the staging of dementia. Br J Psychiatry 1982;140:566–72.PubMedCrossRef Hughes CP, Berg L, Danziger WL, et al. A new clinical scale for the staging of dementia. Br J Psychiatry 1982;140:566–72.PubMedCrossRef
22.
Zurück zum Zitat Kavia RB, Dasgupta R, Fowler CJ. Functional imaging and the central control of the bladder. J Comp Neurol 2005;493:27–32.PubMedCrossRef Kavia RB, Dasgupta R, Fowler CJ. Functional imaging and the central control of the bladder. J Comp Neurol 2005;493:27–32.PubMedCrossRef
23.
Zurück zum Zitat Kertesz A, Davidson W, Fox H. Frontal behavioral inventory: diagnostic criteria for frontal lobe dementia. Can J Neurol Sci 1997;24:29–36.PubMed Kertesz A, Davidson W, Fox H. Frontal behavioral inventory: diagnostic criteria for frontal lobe dementia. Can J Neurol Sci 1997;24:29–36.PubMed
24.
Zurück zum Zitat Kitta T, Kakizaki H, Furuno T, et al. Brain activation during detrusor overactivity in patients with Parkinson’s disease: a positron emission tomography study. J Urol 2006;175:994–8.PubMedCrossRef Kitta T, Kakizaki H, Furuno T, et al. Brain activation during detrusor overactivity in patients with Parkinson’s disease: a positron emission tomography study. J Urol 2006;175:994–8.PubMedCrossRef
25.
Zurück zum Zitat Kono AK, Ishii K, Sofue K, et al. Fully automatic differential diagnosis system for dementia with Lewy bodies and Alzheimer’s disease using FDG-PET and 3D-SSP. Eur J Nucl Med Mol Imaging 2007;34:1490–7.PubMedCrossRef Kono AK, Ishii K, Sofue K, et al. Fully automatic differential diagnosis system for dementia with Lewy bodies and Alzheimer’s disease using FDG-PET and 3D-SSP. Eur J Nucl Med Mol Imaging 2007;34:1490–7.PubMedCrossRef
26.
Zurück zum Zitat Minoshima S, Foster NL, Sima AA, et al. Alzheimer’s disease versus dementia with Lewy bodies: cerebral metabolic distinction with autopsy confirmation. Ann Neurol 2001;50:358–65.PubMedCrossRef Minoshima S, Foster NL, Sima AA, et al. Alzheimer’s disease versus dementia with Lewy bodies: cerebral metabolic distinction with autopsy confirmation. Ann Neurol 2001;50:358–65.PubMedCrossRef
27.
Zurück zum Zitat Neary D, Snowden JS, Gustafson L, et al. Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 1998;51:1546–54.PubMed Neary D, Snowden JS, Gustafson L, et al. Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 1998;51:1546–54.PubMed
28.
Zurück zum Zitat Nour S, Svarer C, Kristensen JK, et al. Cerebral activation during micturition in normal men. Brain 2000;123(Pt 4):781–9.PubMedCrossRef Nour S, Svarer C, Kristensen JK, et al. Cerebral activation during micturition in normal men. Brain 2000;123(Pt 4):781–9.PubMedCrossRef
29.
Zurück zum Zitat Perneczky R, Diehl-Schmid J, Pohl C, et al. Non-fluent progressive aphasia: Cerebral metabolic patterns and brain reserve. Brain Res 2007;1133:178–85.PubMedCrossRef Perneczky R, Diehl-Schmid J, Pohl C, et al. Non-fluent progressive aphasia: Cerebral metabolic patterns and brain reserve. Brain Res 2007;1133:178–85.PubMedCrossRef
30.
Zurück zum Zitat Perneczky R, Wagenpfeil S, Komossa K, et al. Mapping scores onto stages: mini-mental state examination and clinical dementia rating. Am J Geriatr Psychiatry 2006;14:139–44.PubMedCrossRef Perneczky R, Wagenpfeil S, Komossa K, et al. Mapping scores onto stages: mini-mental state examination and clinical dementia rating. Am J Geriatr Psychiatry 2006;14:139–44.PubMedCrossRef
31.
Zurück zum Zitat Pool JL, Ransohoff J. Autonomic effects on stimulating rostral portion of cingulate gyri in man. J Neurophysiol 1949;12:385–92.PubMed Pool JL, Ransohoff J. Autonomic effects on stimulating rostral portion of cingulate gyri in man. J Neurophysiol 1949;12:385–92.PubMed
32.
Zurück zum Zitat Ratnavalli E, Brayne C, Dawson K, et al. The prevalence of frontotemporal dementia. Neurology 2002;58:1615–21.PubMed Ratnavalli E, Brayne C, Dawson K, et al. The prevalence of frontotemporal dementia. Neurology 2002;58:1615–21.PubMed
33.
Zurück zum Zitat Reitan R. Validity of the Trail Making Test as an indicator of organic brain damage. Percept Mot Skills 1985;8:271–6.CrossRef Reitan R. Validity of the Trail Making Test as an indicator of organic brain damage. Percept Mot Skills 1985;8:271–6.CrossRef
34.
Zurück zum Zitat Sakakibara R, Uchida Y, Uchiyama T, et al. Reduced cerebellar vermis activation during urinary storage and micturition in multiple system atrophy: 99mTc-labelled ECD SPECT study. Eur J Neurol 2004;11:705–8.PubMedCrossRef Sakakibara R, Uchida Y, Uchiyama T, et al. Reduced cerebellar vermis activation during urinary storage and micturition in multiple system atrophy: 99mTc-labelled ECD SPECT study. Eur J Neurol 2004;11:705–8.PubMedCrossRef
35.
Zurück zum Zitat Talairach J, Tournoux P. Co-planar stereotactical atlas of the human brain: 3-dimensional proportional system - an approach to cerebral imaging. Thieme Medical Publishers, New York, 1988. Talairach J, Tournoux P. Co-planar stereotactical atlas of the human brain: 3-dimensional proportional system - an approach to cerebral imaging. Thieme Medical Publishers, New York, 1988.
36.
Zurück zum Zitat Thalmann B, Monsch A, CERAD. The Consortium to Establish a Registry for Alzheimer’s Disease. Neuropsychologische Testbatterie. Memory Clinic Basel, Basel, 1997. Thalmann B, Monsch A, CERAD. The Consortium to Establish a Registry for Alzheimer’s Disease. Neuropsychologische Testbatterie. Memory Clinic Basel, Basel, 1997.
37.
Zurück zum Zitat Walters K, Iliffe S, Tai SS, et al. Assessing needs from patient, carer and professional perspectives: the Camberwell Assessment of Need for Elderly people in primary care. Age Ageing 2000;29:505–10.PubMedCrossRef Walters K, Iliffe S, Tai SS, et al. Assessing needs from patient, carer and professional perspectives: the Camberwell Assessment of Need for Elderly people in primary care. Age Ageing 2000;29:505–10.PubMedCrossRef
Metadaten
Titel
Urinary incontinence and its functional anatomy in frontotemporal lobar degenerations
verfasst von
Robert Perneczky
Janine Diehl-Schmid
Hans Förstl
Alexander Drzezga
Florian May
Alexander Kurz
Publikationsdatum
01.03.2008
Verlag
Springer-Verlag
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 3/2008
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-007-0626-8

Weitere Artikel der Ausgabe 3/2008

European Journal of Nuclear Medicine and Molecular Imaging 3/2008 Zur Ausgabe

Society communication

Society communication