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Urinary incontinence and its functional anatomy in frontotemporal lobar degenerations

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

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.

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Acknowledgements

Dr. Diehl-Schmid received KKF and HWP-II grants from the Technical University Munich. However, the sponsor did neither play a role in design and conduct of the study, collection, management, analysis and interpretation of the data nor in the preparation, review or approval of the manuscript.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, Technical University Munich Medical School, Munich, Germany

    Robert Perneczky, Janine Diehl-Schmid, Hans Förstl & Alexander Kurz

  2. Department of Nuclear Medicine, Technical University Munich Medical School, Munich, Germany

    Alexander Drzezga

  3. Department of Urology, Technical University Munich Medical School, Munich, Germany

    Florian May

  4. Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Ismaninger Str. 22, 81675, München, Germany

    Robert Perneczky

Authors
  1. Robert Perneczky
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  2. Janine Diehl-Schmid
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  3. Hans Förstl
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  4. Alexander Drzezga
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  5. Florian May
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  6. Alexander Kurz
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Corresponding author

Correspondence to Robert Perneczky.

Additional information

Robert Perneczky and Janine Diehl-Schmid contributed equally.

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Perneczky, R., Diehl-Schmid, J., Förstl, H. et al. Urinary incontinence and its functional anatomy in frontotemporal lobar degenerations. Eur J Nucl Med Mol Imaging 35, 605–610 (2008). https://doi.org/10.1007/s00259-007-0626-8

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  • DOI: https://doi.org/10.1007/s00259-007-0626-8

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