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27-03-2023 | Overactive Bladder | Original Article

Skin sympathetic nerve activity as a potential biomarker for overactive bladder

Authors: Yu-Chen Chen, Hao-Wei Chen, Tien-Chi Huang, Ting-Yin Chu, Yung-Shun Juan, Cheng-Yu Long, Hsiang-Ying Lee, Shu-Pin Huang, Yu-Peng Liu, Chao-Ju Chen, Meng-Ni Wu, Kuang-Shun Chueh, Ching-Chia Li, Chien-Hung Lee, Wei-Chung Tsai, Wen-Jeng Wu

Published in: World Journal of Urology | Issue 5/2023

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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Piętak PA, Rechberger T (2022) Overactive bladder as a dysfunction of the autonomic nervous system—a narrative review. Eur J Obstet Gynecol Reprod Biol 271:102–107CrossRefPubMed

Gondim R, Gorjão J, Nacif A, Franco I, Barroso U Jr (2021) Evaluation of autonomic function in children and adolescents with overactive bladder. Int Braz J Urol 47(6):1178–1188CrossRefPubMedPubMedCentral

Hubeaux K, Deffieux X, Raibaut P, Le Breton F, Jousse M, Amarenco G (2011) Evidence for autonomic nervous system dysfunction in females with idiopathic overactive bladder syndrome. Neurourol Urodyn 30(8):1467–1472CrossRefPubMed

Choi JB, Kim YB, Kim BT et al (2005) Analysis of heart rate variability in female patients with overactive bladder. Urology 65:1109–1112CrossRefPubMed

Hubeaux K, Deffieux X, Ismael SS et al (2007) Autonomic nervous system activity during bladder filling assessed by heart rate variability analysis in women with idiopathic overactive bladder syndrome or stress urinary incontinence. J Urol 178:2483–2487CrossRefPubMed

Liao WC, Jaw FS (2010) A noninvasive evaluation of autonomic nervous system dysfunction in women with an overactive bladder. Int J Gynaecol Obstet 110:12–17CrossRefPubMed

Kim JC, Joo KJ, Kim JT et al (2010) Alteration of autonomic function in female urinary incontinence. Int Neurourol J 14:232–237CrossRefPubMedPubMedCentral

Im HW, Kim MD, Kim JC, Choi JB (2010) Autonomous nervous system activity in women with detrusor overactivity. Korean J Urol 51(3):183–186CrossRefPubMedPubMedCentral

Ben-Dror I, Weissman A, Leurer MK, Eldor-Itskovitz J, Lowenstein L (2012) Alterations of heart rate variability in women with overactive bladder syndrome. Int Urogynecol J 23(8):1081–1086CrossRefPubMed

10.

Billman GE (2013) The LF/HF ratio does not accurately measure cardiac sympatho-vagal balance. Front Physiol 4:26CrossRefPubMedPubMedCentral

11.

Ates E, Ipekci T, Akin Y, Kizilay F, Kukul E, Guntekin E (2016) Impact of sympathetic dysfunction in the etiology of overactive bladder in women: a preliminary study. Neurourol Urodyn 35(1):26–28CrossRefPubMed

12.

Kusayama T, Wong J, Liu X, He W, Doytchinova A, Robinson EA, Adams DE, Chen LS, Lin SF, Davoren K, Victor RG, Cai C, Dai MY, Tian Y, Zhang P, Ernst D, Rho RH, Chen M, Cha YM, Walega DR, Everett TH 4th, Chen PS (2020) Simultaneous noninvasive recording of electrocardiogram and skin sympathetic nerve activity (neuECG). Nat Protoc 15(5):1853–1877CrossRefPubMed

13.

Huang TC, Chi NY, Lan CS, Chen CJ, Jhuo SJ, Lin TH, Liu YH, Chou LF, Chang CW, Liao WS, Kao PH, Hsu PC, Lee CS, Lin YH, Lee HC, Lu YH, Yen HW, Lin TH, Su HM, Lai WT, Tsai WC, Lin SF, Lee CH (2021) High skin sympathetic nerve activity in patients with recurrent syncope. J Pers Med. 11(11):1053CrossRefPubMedPubMedCentral

14.

Doytchinova A, Hassel JL, Yuan Y, Lin H, Yin D, Adams D, Straka S, Wright K, Smith K, Wagner D et al (2017) Simultaneous noninvasive recording of skin sympathetic nerve activity and electrocardiogram. Heart Rhythm 14:25–33CrossRefPubMed

15.

Jiang Z, Zhao Y, Doytchinova A, Kamp NJ, Tsai WC, Yuan Y, Adams D, Wagner D, Shen C, Chen LS et al (2015) Using skin sympathetic nerve activity to estimate stellate ganglion nerve activity in dogs. Heart Rhythm 12:1324–1332CrossRefPubMedPubMedCentral

16.

Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J 21(1):5–26. https://doi.org/10.1007/s00192-009-0976-9CrossRefPubMed

17.

Hung MJ, Chou CL, Yen TW, Chuang YC, Meng E, Huang ST, Kuo HC (2013) Development and validation of the Chinese Overactive Bladder Symptom Score for assessing overactive bladder syndrome in a RESORT study. J Formos Med Assoc 112(5):276–282. https://doi.org/10.1016/j.jfma.2011.09.020CrossRefPubMed

18.

Choi EP, Lam CL, Chin WY (2014) Validation of the International Prostate Symptom Score in Chinese males and females with lower urinary tract symptoms. Health Qual Life Outcomes 12:1CrossRefPubMedPubMedCentral

19.

Coyne KS, Margolis MK, Hsieh R, Vats V, Chapple CR (2011) Validation of the urinary sensation scale (USS). Neurourol Urodyn 30(3):360–365CrossRefPubMed

20.

Kop WJ, Krantz DS, Nearing BD, Gottdiener JS, Quigley JF, O’Callahan M, DelNegro AA, Friehling TD, Karasik P, Suchday S, Levine J, Verrier RL (2004) Effects of acute mental stress and exercise on T-wave alternans in patients with implantable cardioverter defibrillators and controls. Circulation 109(15):1864–1869. https://doi.org/10.1161/01.CIR.0000124726.72615.60CrossRefPubMed

21.

Gratze G, Mayer H, Skrabal F (2008) Sympathetic reserve, serum potassium, and orthostatic intolerance after endurance exercise and implications for neurocardiogenic syncope. Eur Heart J 29:1531–1541CrossRefPubMed

22.

Pan J, Tompkins WJ (1985) A real-time QRS detection algorithm. IEEE Trans Biomed Eng 32:230–236CrossRefPubMed

23.

Clemens JQ (2013) Afferent neurourology and urologic pain syndromes: current state of the art. Curr Opin Urol 23(6):552–553CrossRefPubMed

24.

Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, Wein A (2020) Campbell Walsh Wein urology, 12th edn. Elsevier, pp 2503–2504

25.

Steers WD, Clemow DB, Persson K, Sherer TB, Andersson KE, Tuttle JB (1999) The spontaneously hypertensive rat: insight into the pathogenesis of irritative symptoms in benign prostatic hyperplasia and young anxious males. Exp Physiol 84(1):137–147CrossRefPubMed

26.

Qu HC, Zhang W, Liu YL, Wang P (2015) Association between polymorphism of β3-adrenoceptor gene and overactive bladder: a meta-analysis. Genet Mol Res 14(1):2495–2501. https://doi.org/10.4238/2015.March.30.7CrossRefPubMed

27.

Yamada S, Niiya R, Ito Y, Kato Y, Onoue S (2022) Comparative characterization of β-adrenoceptors in the bladder, heart, and lungs of rats: alterations in spontaneously hypertensive rats. J Pharmacol Sci 148(1):51–55CrossRefPubMed

28.

Frazier EP, Schneider T, Michel MC (2006) Effects of gender, age and hypertension on beta-adrenergic receptor function in rat urinary bladder. Naunyn-Schmiedeberg’s Arch Pharmacol 373:300–309CrossRef

29.

Liu HT, Chancellor MB, Kuo HC (2009) Decrease of urinary nerve growth factor levels after antimuscarinic therapy in patients with overactive bladder. BJU Int 103(12):1668–1672CrossRefPubMed

30.

Apostolidis A, Popat R, Yiangou Y, Cockayne D, Ford AP, Davis JB (2005) Decreased sensory receptors P2X3 and TRPV1 in suburothelial nerve fibers following intradetrusor injections of botulinum toxin for human detrusor overactivity. J Urol 174:977–983CrossRefPubMed

Title: Skin sympathetic nerve activity as a potential biomarker for overactive bladder
Authors: Yu-Chen Chen
Hao-Wei Chen
Tien-Chi Huang
Ting-Yin Chu
Yung-Shun Juan
Cheng-Yu Long
Hsiang-Ying Lee
Shu-Pin Huang
Yu-Peng Liu
Chao-Ju Chen
Meng-Ni Wu
Kuang-Shun Chueh
Ching-Chia Li
Chien-Hung Lee
Wei-Chung Tsai
Wen-Jeng Wu
Publication date: 27-03-2023
Publisher: Springer Berlin Heidelberg
Keywords: Overactive Bladder
Biomarkers
Published in: World Journal of Urology / Issue 5/2023
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04376-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Skin sympathetic nerve activity as a potential biomarker for overactive bladder

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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