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Objectives: First aim is to evaluate supraspinal LUT control in patients with non-neurogenic overactive bladders (NNOAB) and find out if there are specific differences in supraspinal activation, structural, and functional connectivity that might be characteristic for overactive bladder (OAB). The second aim is to evaluate the potential effect of intradetrusor injections of botulinum neurotoxin type A (BoNTA) on aberrant supraspinal LUT control in NNOAB. The third aim is to evaluate supraspinal LUT control in Multiple Sclerosis (MS) patients compared to healthy controls and NNOAB subjects to investigate the specific differences in supraspinal activation, and structural, and functional connectivity that might be characteristic for OAB in MS. The fourth aim is to investigate the potential involvement of abnormal C-fibre sensitivity in the pathophysiology of OAB symptoms in NNOAB and MS patients.
Importance and impact of the study: This project is the first to investigate supraspinal LUT control in healthy subjects and patients with neurogenic and non-neurogenic LUT dysfunction using fMRI in combination with diffusion tensor imaging (DTI) and functional connectivity (FC) analysis. In addition this project includes the first study investigating the effect of BoNTA on the supraspinal control which should provide profound insight into the supraspinal neuronal mechanisms and networks responsible for LUT control. The findings will help to verify, amend, and/or adjust neuronal circuitry models which were established from findings in healthy subjects in the context of neurogenic and non-neurogenic LUT dysfunction.