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Skin sympathetic nerve activity as a potential biomarker for overactive bladder

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World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

Abnormalities in autonomic function are associated with an overactive bladder (OAB). Heart rate variability is generally used as the sole assessment of autonomic activity; however, we utilized neuECG, a novel method of recording skin electrical signals, to assess autonomic nervous function in healthy controls and patients with OAB before and after treatment.

Methods

The prospective sample included 52 participants: 23 patients newly diagnosed with OAB and 29 controls. Autonomic function was assessed in all participants in the morning using neuECG, which analyzed the average skin sympathetic nerve activity (aSKNA) and electrocardiogram simultaneously. All patients with OAB were administered antimuscarinics; urodynamic parameters were assessed before treatments; autonomic and bladder functions using validated questionnaires for OAB symptoms were evaluated before and after OAB treatment.

Results

Patients with OAB had significantly higher baseline aSKNA (p = 0.003), lower standard deviation of the normal-to-normal beat intervals, lower root mean square of the successive differences, lower high-frequency, and higher low-frequency than did controls. Baseline aSKNA had the highest value in predicting OAB (AUROC = 0.783, p < 0.001). The aSKNA was negatively correlated with first desire and normal desire in urodynamic studies (both p = 0.025) and was significantly decreased after treatment at rest, stress, and recovery phases, as compared to those before treatment (p = 0.046, 0.017, and 0.017, respectively).

Conclusion

Sympathetic activity increased significantly in patients with OAB compared to that in healthy controls, and decreased significantly post-treatment. Higher aSKNA is associated with decreased bladder volume at which voiding is desired. SKNA may be a potential biomarker for diagnosing OAB.

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Data availability statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors appreciate the generous support from the Kaohsiung Medical University Hospital, Kaohsiung Medical University, Health and the Welfare Ministry to Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University Hospital at Kaohsiung Medical University and Kaohsiung Medical University Regenerative Medicine and Cell Therapy Research Center.

Funding

This research was funded partly by Kaohsiung Medical University Hospital (Grant Number: KMUH-110-0M57, KMUH105-5M07, KMUH111-1M48).

Author information

Author notes

  1. Wei-Chung Tsai and Wen-Jeng Wu contributed equally to this study as the corresponding authors.

Authors and Affiliations

  1. Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Yu-Chen Chen, Hao-Wei Chen, Yung-Shun Juan, Hsiang-Ying Lee, Shu-Pin Huang, Yu-Peng Liu, Chao-Ju Chen, Meng-Ni Wu, Kuang-Shun Chueh & Wen-Jeng Wu

  2. Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Yu-Chen Chen, Hao-Wei Chen, Yung-Shun Juan, Hsiang-Ying Lee, Shu-Pin Huang, Ching-Chia Li & Wen-Jeng Wu

  3. Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan

    Yu-Chen Chen & Yung-Shun Juan

  4. Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan

    Hao-Wei Chen & Kuang-Shun Chueh

  5. Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Tien-Chi Huang & Wei-Chung Tsai

  6. Master of Health Care Management, Department of Business Management, National Sun Yat-Sen University, Kaohsiung, Taiwan

    Ting-Yin Chu

  7. Department of Obstetrics and Gynecology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Cheng-Yu Long

  8. Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chao-Ju Chen

  9. Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Meng-Ni Wu

  10. Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chien-Hung Lee

  11. Drug Development and Value Creation Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan

    Wei-Chung Tsai

  12. Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Chien-Hung Lee

  13. NPUST College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan

    Chien-Hung Lee

  14. Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Wei-Chung Tsai & Wen-Jeng Wu

  15. Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Hsiang-Ying Lee & Wen-Jeng Wu

  16. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Cheng-Yu Long

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  1. Yu-Chen Chen
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Contributions

Conceptualization, Y-CC, H-WC and W-CT; Investigation, Y-CC, H-WC and W-CT; Data analysis, Y-CC, W-CT and C-HL; Writing—original draft preparation, Y-CC; Writing—review and editing, Y-CC, H-WC, T-CH, T-YC, Y-SJ, C-YL, H-YL, S-PH, Y-PL, C-JC, M-NW, K-SC, C-CL, W-CT and W-JW; Project administration, Y-CC, H-WC, W-CT and W-JW; Funding acquisition, Y-CC and W-CT.

Corresponding author

Correspondence to Wei-Chung Tsai.

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Conflict of interest

The authors declare no conflict of interest for this research.

Ethical approval

This study was approved by the Institutional Review Board of Kaohsiung Medical University Hospital (KMUHIRB-E(II)-20180010) and was registered at ClinicalTrials.gov (identifier: NCT03243448).

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All participants provided written informed consent.

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The manuscript does not contain any individual personal data in any form. All authors reviewed and approved the final version of the manuscript.

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Supplementary Information

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Supplementary file1 (DOCX 14 KB)

345_2023_4376_MOESM2_ESM.png

Fig. S1 Original recordings of SKNA from a representative participant in each group. SKNA, skin sympathetic nerve activity (PNG 90 KB)

345_2023_4376_MOESM3_ESM.png

Fig. S2 Original recordings of SKNA from the patient with OAB before and after the treatment. SKNA, skin sympathetic nerve activity; OAB, overactive bladder (PNG 51 KB)

Supplementary file4 (DOC 48 KB)

Supplementary file5 (DOC 48 KB)

Supplementary file6 (DOC 66 KB)

Supplementary file7 (DOC 42 KB)

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Chen, YC., Chen, HW., Huang, TC. et al. Skin sympathetic nerve activity as a potential biomarker for overactive bladder. World J Urol 41, 1373–1379 (2023). https://doi.org/10.1007/s00345-023-04376-1

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