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Title: Investigating white matter changes underlying overactive bladder in multiple sclerosis with diffusion MRI
Author: Yang, Xixi
ISNI:       0000 0004 8508 1881
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2019
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Lower urinary tract symptoms (LUTS) are presented in more than 80% of multiple sclerosis (MS) patients. Current understanding of LUT control is based on studies exploring activities in grey matter (GM) and investigating functional correlations with LUTS. The relationship between white matter (WM) changes and overactive bladder (OAB) symptoms are limited to findings in small vessel disease, and the nature of the association between WM changes and OAB symptoms is poorly understood. Advanced diffusion-weighted magnetic resonance imaging (MRI) techniques provide non-invasive techniques to study WM abnormalities and correlates to clinical observations. The overarching objectives of this work are to explore WM abnormalities subtending OAB symptoms in MS, and to reconstruct the structural network underpinning the working model of lower urinary tract (LUT) control. Using Tract-Based Spatial Statistics (TBSS), OAB symptoms related WM abnormalities in MS can be identified, and a structural network subtending OAB symptoms in MS can be subsequently created. The findings of this work illustrate the correlation between OAB symptoms severity and WM abnormalities in MS. These were observed in regions in frontal lobes and non-dominant hemisphere, including corpus callosum, anterior corona radiata bilaterally, right anterior thalamic radiation, superior longitudinal fasciculus bilaterally, and right inferior longitudinal fasciculus. The structural network created for OAB symptoms in MS connected regions known to be involved in the working model of LUT control, and the network identified connectivity between insula and frontal lobe, which is the key circuit for perception of bladder fullness. Moreover, structural connectivity between insula-temporal lobe and insula-occipital lobe were observed, which may underpin changes seen in functional MRI (fMRI) studies. The novel findings of this study present WM abnormalities and structural connectivity subtending LUTS in MS with diffusion-weighted imaging (DWI). The techniques used in this work can be applied to other patterns of LUTS and other neurological diseases.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available