Brain MRI Lesions are Related to Bowel Incontinence in Multiple Sclerosis

Fröhlich K, Linker R, Engelhorn T, Dörfler A, Lee DH, Huhn K, Schwab S, Hilz MJ, Seifert F, Winder K (2018)

Publication Type: Journal article

Publication year: 2018

Journal

Journal of Neuroimaging Wiley-Blackwell / SAGE Publications (UK and US)

Abstract

BACKGROUND AND PURPOSE: Bowel incontinence in multiple sclerosis might be associated with specific lesion sites. This study intended to determine associations between bowel incontinence and cerebral multiple sclerosis lesions using a voxel-wise lesion symptom mapping analysis. METHODS: We conducted a retrospective study of multiple sclerosis patients with self-reported bowel incontinence and matched controls. Lesions were manually outlined on T2-weighted MRI scans and transformed into stereotaxic space. We performed a voxel-wise subtraction analysis subtracting the lesion overlap of patients without from patients with bowel incontinence. Finally, we compared the absence or presence of bowel incontinence between patients with and without lesions in a given voxel using the Liebermeister test. RESULTS: A total of 51 patients were included in the study. The analysis yielded associations between bowel incontinence and lesions in the supramarginal gyrus of the left secondary somatosensory cortex and another lesion cluster in the right parahippocampal gyrus and amygdala. CONCLUSIONS: Our analysis indicates associations between bowel incontinence and lesions in the left supramarginal gyral area contributing to integrating anorectal-visceral sensation and in the right parahippocampal gyrus and amygdala contributing to generating visceral autonomic arousal states. Moreover, our results suggest left hemispheric dominance of sensory visceral integration, while limbic areas of the right hemisphere seem to contribute to the autonomic component of the defecation process. A limitation of our study is the retrospective evaluation of the bowel incontinence status based on medical records. Further research should evaluate the bowel incontinence status in multiple sclerosis patients prospectively to overcome the limitations of the current study.

Authors with CRIS profile

Katharina Fröhlich Medizinische Fakultät Ralf Linker Department of Neurology Tobias Martin Engelhorn Department of Neuroradiology Arnd Dörfler Department of Neuroradiology De-Hyung Lee Medizinische Fakultät Stefan Schwab Lehrstuhl für Neurologie Max-Josef Hilz Heisenbergprofessur für Neuroimmunologie Frank Seifert Medizinische Fakultät

How to cite

APA:

Fröhlich, K., Linker, R., Engelhorn, T., Dörfler, A., Lee, D.-H., Huhn, K.,... Winder, K. (2018). Brain MRI Lesions are Related to Bowel Incontinence in Multiple Sclerosis. Journal of Neuroimaging. https://dx.doi.org/10.1111/jon.12589

MLA:

Fröhlich, Katharina, et al. "Brain MRI Lesions are Related to Bowel Incontinence in Multiple Sclerosis." Journal of Neuroimaging (2018).

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