Urinary Incontinence, Urge Clinical Trial
Official title:
Examining the Brain's Control Systems in Normal and Overactive Bladder Using DTI and Functional MRI
Urgency incontinence (where the bladder muscles contract suddenly, causing an immediate urge to urinate that is difficult to prevent) is commonly experienced in patients with overactive bladder. New findings have discovered that urgency incontinence may be connected to the interactions of certain regions of the brain and the bladder. Although this is a common problem, researchers still do not know how these interactions impact the process of urgency incontinence. The purpose of this study is to better understand how the brain functions, by using Magnetic Resonance Imaging (MRI) machine and Diffusion Tensor Imaging (DTI) to create images of the brain during different bladder states.
One devastating manifestation of overactive bladder is urgency incontinence. Although urgency incontinence is a common problem with profound clinical, social and psychological consequences, little is understood about its underlying cause. The involuntary detrusor overactivity (DO) often associated with the disease points to a possible abnormality in voluntary control of the spinobulbospinal voiding reflex by a higher order neuronal network. Recent functional MRI (fMRI) and PET studies have identified increased brain activity during bladder filling and voiding in normal subjects from higher order cognitive control centers. In addition, there are now data to suggest that interactions between these brain areas, which include the pontine micturition center (PMC), periaqueductal gray (PAG), thalamus, insula, dorsal anterior cingulate and prefrontal cortex, may be abnormal in patients with urgency incontinence. Despite these encouraging findings, we do not yet know how these regions are interacting with each other, or to other, unknown but important, regions in the brain. Nor do we know how this interaction might play a role in this disease process. Expanding our knowledge of how these regions are integrated to achieve continence and, importantly, what aspects of this complex circuitry are atypical in patients with urge incontinence is key to our future therapeutic endeavors. With this in mind, the goal of this study is to better characterize the functional integration (i.e. functional connectivity) of the brain's control networks in relation to typical and atypical bladder function. We aim to identify distinct differences in the brain's functional and anatomic topography in women with and without urgency incontinence. Our approach not only has the potential to advance our understanding of the higher level pathophysiology of this disease process, but could also lead to novel more centrally acting therapeutic approaches for treatment of urgency incontinence. ;
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT06201013 -
Efficacy and Safety of Vitamin D in the Treatment of OAB-wet in Children
|
N/A | |
Completed |
NCT02001714 -
Group Learning Achieves Decreased Incidents of Lower Urinary Symptoms
|
N/A | |
Not yet recruiting |
NCT00523068 -
Pharmacological vs Surgical Treatment for Mixed Incontinence
|
Phase 4 | |
Enrolling by invitation |
NCT05404386 -
Effect of Mobile Application on Urinary Incontinence
|
N/A | |
Recruiting |
NCT05362292 -
TReating Incontinence for Underlying Mental and Physical Health
|
Phase 4 | |
Completed |
NCT01959347 -
Combined Treatment for Mixed Incontinence
|
Phase 3 | |
Recruiting |
NCT04271852 -
An Experimental Protocol for the Study of Brain Functional Magnetic Resonance Imaging in Female With Urgent Urinary Incontinence
|
N/A | |
Completed |
NCT01971437 -
Cystoscopy and Cystodistension; Therapeutic and Aetiological Aspect in Overactive Bladder
|
N/A | |
Terminated |
NCT01464372 -
Electromagnetic Stimulation for the Treatment of Urge Urinary Incontinence and Overactive Bladder
|
Phase 3 | |
Completed |
NCT04528784 -
Feasibility Study of Transcutaneous Tibial Nerve Stimulation for Urinary Symptoms in People With Multiple Sclerosis
|
N/A | |
Recruiting |
NCT05874375 -
UCon Treatment of Overactive Bladder (OAB) in Males
|
N/A | |
Recruiting |
NCT05735522 -
Effectiveness of Magnetic Stimulation in the Treatment of Female UUI.
|
N/A | |
Active, not recruiting |
NCT03327948 -
Axonics SacRal NeuromodulaTIon System for Urinary Urgency Incontinence TreatmeNt
|
N/A | |
Completed |
NCT04652869 -
Mindfulness + tDCS to Reduce Urgency Incontinence in Women
|
N/A | |
Completed |
NCT03543566 -
Bladder Antimuscarinic Medication and Accidental Bowel Leakage
|
||
Active, not recruiting |
NCT05308979 -
Intradetrusor Botulinum Toxin A for OAB Via 1 Versus 10 Injections: A Randomized Clinical Trial
|
Phase 4 | |
Recruiting |
NCT05250908 -
INTIBIA Pivotal Study
|
N/A | |
Withdrawn |
NCT02434874 -
Sacral Nerve Stimulation to Treat Urgency Urinary Incontinence With Wireless Neuromodulation
|
N/A | |
Completed |
NCT04024085 -
Time to be Ready to Void: a New Tool to Assess the Time Needed to Perform Micturition in Multiple Sclerosis
|
||
Withdrawn |
NCT03043222 -
Innovative Minimally Invasive Options in Treatment of Urinary Problems Related to Prostate Enlargement (BPH) in Men
|
N/A |