Investigation of Brain Mechanisms Involved in the Urinary Continence Mechanism Associated With Aging

Description

Urge urinary incontinence (UUI) is a common problem in older people which vastly reduces quality of life, yet the cause and mechanism of disease are not well understood. This study will characterize brain control of the bladder in young and old continent individuals and age-matched incontinent counterparts. This will expand the investigators current knowledge of how the brain controls the bladder, how that control changes with age and disease, and suggest new targets to guide development of better treatment.

Conditions

Urgency Urinary Incontinence

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Study Overview

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Study Details

Study overview

Urge urinary incontinence (UUI) is a common problem in older people which vastly reduces quality of life, yet the cause and mechanism of disease are not well understood. This study will characterize brain control of the bladder in young and old continent individuals and age-matched incontinent counterparts. This will expand the investigators current knowledge of how the brain controls the bladder, how that control changes with age and disease, and suggest new targets to guide development of better treatment.

Investigation of Brain Mechanisms Involved in the Urinary Continence Mechanism Associated With Aging

Investigation of Brain Mechanisms Involved in the Urinary Continence Mechanism Associated With Aging

Condition
Urgency Urinary Incontinence
Intervention / Treatment

-

Contacts and Locations

Pittsburgh

University of Pittsburgh, Pittsburgh, Pennsylvania, United States, 15213

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * 'Old' (community-dwelling, mentally and functionally intact ambulatory women aged 65+ years) or 'Young' (equivalent women aged 18-45)
  • * 'Wet' (those who meet the International Continence Society definition of urgency urinary incontinence (urinary leakage accompanied by a sudden, strong urge to void which is difficult to defer) \>5 times per week, for 3 months despite treatment for reversible causes (e.g., Urinary tract infection) and confirmed by a mean of one episode per day of UUI on 3-day bladder diary) or 'Dry' (women without current or past UUI or other lower urinary tract symptoms.) Infrequent stress incontinence of a small amount is acceptable.
  • * Urge-predominant mixed incontinence is acceptable provided the subject is able to differentiate between stress incontinence (SUI - leakage that coincides instantaneously with cough, laugh, exercise) and urgency incontinence, i.e., leakage accompanied by a sudden strong urge to void that is difficult to defer.
  • * Those with current or previous use of anticholinergic/beta-3 agonist medications will be considered for the study if they are willing to go through a washout period of at least 4 weeks of duration.
  • * Current or prior treatment for UUI
  • * Leakage on bladder diary not ascribed to minimal SUI (see bullet above)
  • * Cognitive impairment:
  • * MoCA\<26
  • * inability to perform a voiding diary/pad test
  • * inability to reliably take daily medication
  • * inability to comply with fMRI testing
  • * Impaired mobility
  • * Medical instability:
  • * severe uncontrolled hypertension \>180mmHg systolic or \>100mmHg diastolic
  • * potential major changes in medical management over the course of the study period (i.e. upcoming surgery/treatment)
  • * frailty according to the Fried criteria
  • * MRI incompatibility:
  • * contraindicated metal implants
  • * claustrophobia
  • * unidentified/untested compatibility of metal implants
  • * Medication incompatibility:
  • * allergy to study medication (all prophylactic antibiotic choices)
  • * interaction of prophylactic antibiotic choices with current medications
  • * expected change in medication during the study
  • * Neurological conditions:
  • * spinal cord injury;
  • * multiple sclerosis
  • * clinically apparent lesions (e.g. lacunae associated with stroke)
  • * prior stroke
  • * Parkinson's Disease/ALS/MSA
  • * any clinically apparent neurological condition
  • * Lower urinary tract comorbidities/treatment:
  • * history of pelvic irradiation
  • * bladder or advanced uterine cancer
  • * possible urethral obstruction (advanced prolapse \[POP-Q\>II\] or Qmax\<12 ml/s on free flow)
  • * urinary retention (PVR \>200 ml)
  • * Interstitial Cystitis/Bladder Pain Syndrome
  • * artificial sphincter implant
  • * Botox treatment for UUI within 1 year
  • * Neuromodulation treatment for UUI
  • * Other comorbidities:
  • * uncontrolled depression (PHQ-9 ≥10)

Ages Eligible for Study

18 Years to

Sexes Eligible for Study

FEMALE

Accepts Healthy Volunteers

Yes

Collaborators and Investigators

University of Pittsburgh,

Becky Clarkson, PhD, PRINCIPAL_INVESTIGATOR, University of Pittsburgh

Study Record Dates

2025-11-30