Objective: To present the prefrontal cortex activity in patients with Parkinson’s disease (PD) and evaluated the association between prefrontal cortex and lower urinary tract dysfunction (LUTD) in PD.

Background: Patients with PD frequently have LUTD. The mechanism of LUTD in PD was partly clarified and it was reported that nigrostriatal degeneration resulted in micturition hyper-reflexia (i.e. detrusor overactivity). However the association between other central nervous systems and LUTD in PD have yet been uncertain. The prefrontal cortex has been mainly implicated in executive function, and these functions are disturbed in patients with PD. The prefrontal cortex has been also regarded as a higher centre for micturition, and it is hypothesized that this part is involved in bladder function such as planning and suppressing micturition. Recently functional neuroimaging studies using PET, fMRI and SPECT have shown activation of prefrontal area during withholding of urine or a full bladder. A part of these findings was reported to be abnormally weak in patients with urge incontinence or detrusor overactivity (DO). Functional near-infrared spectroscopy (fNIRS) is useful in monitoring the cortical activity in response.

Methods: We recruited 6 patients with PD, including 2 patients with increased bladder sensation and 4 patients with DO. The fNIRS prove was placed on two area (right and left) of the subject’s frontal head, and we measured oxy-Hb concentratio in bilateral anterior parts of prefrontal cortex (may be Brodmann’s area 9, 10) during bladder filling in cystometry by fNIRS (NIRO 200, Hamamatsu Photonics Inc,Japan).

Results: In a case with increased bladder sensation, the oxy-Hb concentration gradually increased during storage, but it was small. Furthermore, in a case with DO, the oxy-Hb also increased and particular change was found during DO occurring, but it was also small. In deed, these changing rates were smaller than those in patients without IBS and DO.

Conclusions: We showed the specific changes of oxy-Hb concentration synchronised with normal and abnormal bladder filing in bilateral prefrontal cortex of patients with PD by using fNIRS. In patients with PD, dysfunction of prefrontal cortex may be involved in LUTD, in particular DO.

A part of data was presented in ICS 2011.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/detrusor-overactivity-is-associated-with-frontal-dysfunction-in-patients-with-parkinsons-disease/