Although urinary incontinence in stroke survivors can substantially impact the patient's quality of life, the underlying neuropsychological mechanisms and its neural basis have not been adequately investigated. Therefore, we investigated this topic via neuropsychological assessment and neuroimaging in a cross-sectional study.
We recruited 71 individuals with cerebrovascular disease. The relationship between urinary incontinence and neuropsychological indices was investigated using simple linear regression analysis or Mann-Whitney U test, along with other explanatory variables, e.g., severity of overactive bladder. Variables with a p-value of <0.1 in the simple regression analysis were entered in the final multiple linear regression model to control for potential confounding factors. To carry out an in-depth examination of the neuroanatomical substrate for urinary incontinence, voxel-based lesion-behavior mapping was performed using MRIcron software.
Behavioral control deficits and severity of overactive bladder were closely related to severity of urinary incontinence. The voxel-based lesion-behavior mapping suggests a potential role for ventromedial prefrontal cortex lesioning in the severity of urinary incontinence, although this association is not statistically significant.
Post-stroke urinary incontinence is closely related to two factors: neurogenic overactive bladder, a physiological disinhibition of micturition reflex, and cognitive dysfunction, characterized by behavior control deficits.
Neuropsychologia. 2024 Jun 19 [Epub ahead of print]
Michitaka Funayama, Akihiro Koreki, Taketo Takata, Yoshitaka Nakagawa, Masaru Mimura
Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga, Tochigi, 326-0843, Japan; Department of Rehabilitation, Edogawa Hospital, Edogawa, Tokyo, 133-0052, Japan; Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, 160-0016, Japan. Electronic address: ., Department of Psychiatry, National Hospital Organization Shimofusa Psychiatric Medical Center, Chiba, 266-0007, Japan., Department of Neuropsychiatry, Ashikaga Red Cross Hospital, Ashikaga, Tochigi, 326-0843, Japan., Department of Rehabilitation, Edogawa Hospital, Edogawa, Tokyo, 133-0052, Japan., Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, 160-0016, Japan.