title: Overactive bladder in Parkinson's disease: alteration of brainstem raphe detected by transcranial sonography.
abstract: Urinary dysfunction is very common in idiopathic Parkinson's disease (PD) and manifests primarily with symptoms of overactive bladder (OAB). Affection of central serotonergic systems has been suggested to play a role in OAB. The objective of this study was to evaluate whether in PD patients with OAB symptoms a specific alteration of the brainstem raphe (BR), which contains serotonergic neurons, can be detected with transcranial sonography (TCS). Of 116 PD patients enrolled, 19 had PD-related OAB symptoms (OAB+) unlike remaining 97 patients (OAB-). Patients were examined by a sonographer blinded to the clinical data. Reduced echogenicity of BR was found in 12 (63%) OAB+ patients but only in 18 (19%) of 93 assessable OAB- patients (Mann-Whitney U-test, P < 0.001). In OAB+ patients, lower raphe echogenicity score was associated with longer duration of OAB symptoms (anova, P = 0.033). Other TCS findings such as echogenicity of substantia nigra, thalami, lenticular and caudate nuclei, and widths of third and lateral ventricles did not differ between OAB+ and OAB- patients. TCS findings suggest a pathogenetic role of BR in OAB related to PD. Alterations may reflect disturbance of its central serotonergic system.
authors.affiliation: Department of Neurology, University of Rostock, Rostock, Germany. uwe.walter@med.uni-rostock.de
authors.forename: U
authors.initials: U
authors.lastname: Walter
authors.forename: D
authors.initials: D
authors.lastname: Dressler
authors.forename: A
authors.initials: A
authors.lastname: Wolters
authors.forename: M
authors.initials: M
authors.lastname: Wittstock
authors.forename: R
authors.initials: R
authors.lastname: Benecke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001933:Brain Stem / Q000000981:diagnostic imaging / Q000503:physiopathology; D003704:Dementia / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology* / Q000523:psychology; D011903:Raphe Nuclei / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017585:Ultrasonography, Doppler, Transcranial; D053201:Urinary Bladder, Overactive / Q000209:etiology*