Inhibitory control task is decreased in vascular incontinence patients
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RESEARCH ARTICLE
Inhibitory control task is decreased in vascular incontinence patients Hiroyuki Haruta • Ryuji Sakakibara • Tsuyoshi Ogata • Jalesh Panicker Clare J. Fowler • Fuyuki Tateno • Masahiko Kishi • Yohei Tsuyusaki • Tomoyuki Uchiyama • Tatsuya Yamamoto
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Received: 22 December 2011 / Accepted: 3 January 2013 / Published online: 19 January 2013 Ó Springer-Verlag Berlin Heidelberg 2013
Abstract Objective ‘Vascular incontinence’ is a part of elderly incontinence due to cerebral white matter change (WMC). We studied the relationship between performance on several cognitive tasks and urodynamic detrusor overactivity (DO) in patients with vascular incontinence. Methods We recruited 40 patients with lower urinary tract symptoms due to WMC [20 male, 20 female; mean age 77 years (60–89 years)]. Other neurologic, urologic, and systemic causes of LUT dysfunction were excluded. All patients underwent urodynamics tests and two sets of cognitive tasks, i.e., the Mini-Mental State Examination (MMSE) (general cognitive tasks), and the Frontal Assessment Battery (FAB) (frontal lobe tasks). Results The most common urinary symptom was urinary urgency (27 patients), followed by urinary incontinence (26) and nocturnal urinary frequency (25). The urodynamic testing revealed DO in 22 patients. The cognitive testing revealed that the patients’ mean MMSE score was 25.8 (range 15–30), and their mean FAB score was 13.6 (4–18). There was no relationship between DO and the total MMSE or FAB score, but our analysis of the relationship between DO and the six subdomains of the FAB (conceptualization, H. Haruta R. Sakakibara (&) C. J. Fowler F. Tateno M. Kishi Neurology, Internal Medicine, Sakura Medical Center, Toho University, 564-1 Shimoshizu, Sakura 285-8741, Japan e-mail: [email protected] T. Ogata J. Panicker Uro-Neurology, National Hospital for Neurology & Neurosurgery, Queen Square, London, UK Y. Tsuyusaki T. Uchiyama T. Yamamoto Neurology, Chiba University, Chiba, Japan
mental flexibility, programming, sensitivity to interference, inhibitory control, and environmental autonomy) revealed a significant relationship between DO and the inhibitory control task (p \ 0.005). Conclusions The results of the present study showed that performance on an inhibitory control task is decreased in vascular incontinence patients with DO. Keywords White matter change Urinary incontinence Frontal lobe Frontal assessment battery Detrusor overactivity
Introduction The incidence of urinary frequency/urgency (also called overactive bladder) with or without incontinence in the general population over 40 years is estimated to be 12.4–16.6 % [1–3]. However, the prevalence increases significantly with age (35–50 %) [3]. The mechanism of incontinence in the frail elderly is age-related changes in the bladder itself [4] or changes in the central nervous system innervation of the bladder [5]. It has been contended that there may be an important cerebral vascular component in elderly incontinence [6–8]. Patients with
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