myelin-basic-protein and Urinary-Incontinence

Multiple sclerosis affects the lower urinary tract in many patients. The relationship between lower urinary tract abnormalities and disease-related parameters of multiple sclerosis is not well described. We screened urologically and neurologically 212 patients according to a standard protocol. Micturition complaints were noted in 52% of the patients and urodynamic abnormalities were found in 64%. A statistical correlation was found between detrusor hyperactivity and detrusor hypoactivity with disease-related parameters, that is disease duration, disability status, myelin basic protein concentration in the cerebrospinal fluid and neurophysiological investigations. No relationship was found between detrusor hypersensibility or detrusor hyposensibility and the aforementioned disease-related parameters. In 1 patient upper urinary tract abnormalities were noted in combination with urodynamic abnormalities. We conclude that lower urinary tract abnormalities can be found in every patient with multiple sclerosis unrelated to the state of the disease. Severe upper urinary tract abnormalities are rare.

Topics: Adolescent; Adult; Aged; Anal Canal; Evoked Potentials, Somatosensory; Female; Humans; Male; Middle Aged; Multiple Sclerosis; Myelin Basic Protein; Pressure; Reaction Time; Reflex; Sex Characteristics; Urethra; Urinary Bladder; Urinary Bladder Diseases; Urinary Incontinence; Urination; Urination Disorders; Urodynamics

The potential evoked at the surface of the cerebral cortex of a guinea pig, by stimulation of the contralateral forepaw, usually consists of an initial double positive wave whose waveform remains unchanged during rapid stimulation. In a guinea pig with experimental allergic encephalomyelitis (EAE) the response is attenuated at low frequencies of stimulation. Observations were also made on animals with experimental allergic neuritis (AEN). These animals showed a peripheral specificity for decreased conduction velocity, but have normal cortical evoked responses. Histological studies were undertaken in parallel with the electrophysiological studies and the concordance and discordance between the two is discussed. We conclude that there is no evident correlation between the severity of the electrophysiological effects and the histological lesions. An attempt was also made to induce an immunological challenge in guinea pigs, in the same way that EAE and EAN is produced, by the injection of synaptosomes. No clinical signs or alterations in the histology or electrophysiology of the animals were seen. A discussion is included on the elucidation of the site of action of EAE by discriminating between the direct effects on myelin and synapses and by the indirect effects of myelin damage on synapses. No firm conclusion is reached and the matter is left for further analysis in the subsequent paper. Finally, the neurophysiological alterations, demonstrated in the EAE and EAN situations, are discussed in terms of a humoral factor possibly acting on the myelin sheath and indirectly affecting synaptic function. This matter is further discussed in the subsequent paper.

Topics: Animals; Central Nervous System; Cerebral Cortex; Disease Models, Animal; Electric Stimulation; Encephalomyelitis, Autoimmune, Experimental; Evoked Potentials; Fecal Incontinence; Forelimb; Guinea Pigs; Humans; Myelin Basic Protein; Myelin Sheath; Neural Conduction; Neuritis; Paralysis; Rats; Sciatic Nerve; Synaptosomes; Urinary Incontinence