Urinary Incontinence and Alzheimer's Disease: Insights From Patients and Preclinical Models.
Urinary Incontinence and Alzheimer's Disease: Insights From Patients and Preclinical Models.
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DOI：
10.3389/fnagi.2021.777819
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发表时间：
2021
影响因子：
4.8
通讯作者：
Lamb LE
中科院分区：
文献类型：
--
作者：
Bartolone SN;Sharma P;Chancellor MB;Lamb LE
阿尔茨海默病影响大部分老年痴呆患者，并且基于存在于大脑中的淀粉样蛋白斑块和神经纤维缠结（NFT）来诊断。尿失禁（UI）经常在老年人群中发现，多项研究表明，它在阿尔茨海默病患者中比那些具有正常认知功能的患者更常见。然而，UI增加与阿尔茨海默病之间的联系仍不清楚。存在于大脑排尿中心的淀粉样斑块和NFT可能导致膀胱信号丢失，导致无法正常排尿。此外，随着阿尔茨海默病的进展，患者变得不太可能认识到需要或理解适当的时间和地点来排尿。有几种针对膀胱和大脑中存在的毒蕈碱和β3肾上腺素能受体的UI治疗方法。虽然这些治疗可能有助于UI，但它们通常会对大脑产生影响，并产生认知障碍副作用。乙酰胆碱酯酶抑制剂通常用于治疗阿尔茨海默病，并直接对抗用于UI的抗毒蕈碱类药物的作用，使得阿尔茨海默病患者的UI管理变得困难。目前已有超过200种阿尔茨海默病的临床前模型，然而，在这些模型中对排尿功能障碍的研究很少。有初步数据表明，这些模型与阿尔茨海默病患者有类似的排尿行为，但需要更多的研究来了解UI和阿尔茨海默病之间的联系，并发现更好的治疗方案来同时管理两者。
Alzheimer’s disease effects a large percentage of elderly dementia patients and is diagnosed on the basis of amyloid plaques and neurofibrillary tangles (NFTs) present in the brain. Urinary incontinence (UI) is often found in the elderly populations and multiple studies have shown that it is more common in Alzheimer’s disease patients than those with normal cognitive function. However, the link between increased UI and Alzheimer’s disease is still unclear. Amyloid plaques and NFTs present in micturition centers of the brain could cause a loss of signal to the bladder, resulting in the inability to properly void. Additionally, as Alzheimer’s disease progresses, patients become less likely to recognize the need or understand the appropriate time and place to void. There are several treatments for UI targeting the muscarinic and β3 adrenergic receptors, which are present in the bladder and the brain. While these treatments may aid in UI, they often have effects on the brain with cognitive impairment side-effects. Acetylcholine esterase inhibitors are often used in treatment of Alzheimer’s disease and directly oppose effects of anti-muscarinics used for UI, making UI management in Alzheimer’s disease patients difficult. There are currently over 200 pre-clinical models of Alzheimer’s disease, however, little research has been done on voiding disfunction in these models. There is preliminary data suggesting these models have similar voiding behavior to Alzheimer’s disease patients but much more research is needed to understand the link between UI and Alzheimer’s disease and discover better treatment options for managing both simultaneously.
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DOI：
10.1590/s1677-5538.ibju.2015.0664
发表时间：
2017-03
期刊：
International braz j urol : official journal of the Brazilian Society of Urology
影响因子：
--
作者：
Jung HB;Choi DK;Lee SH;Cho ST;Na HR;Park MH
通讯作者：
Park MH
影响因子：
2.9
作者：
Dong, Hongxin;Yuede, Carla M.;Coughlan, Carolyn A.;Murphy, Keely M.;Csernansky, John G.
通讯作者：
Csernansky, John G.
影响因子：
4
作者：
HELLSTROM, L;EKELUND, P;SKOOG, I
通讯作者：
SKOOG, I
影响因子：
10.3
作者：
Bogner, Hillary R.;O'Donnell, Alison J.;Joo, Jin Hui
通讯作者：
Joo, Jin Hui
影响因子：
3.8
作者：
Hall AM;Roberson ED
通讯作者：
Roberson ED