Resting-state fMRI in women with functional constipation with or without stress urinary incontinence

Background: No prior research has investigated whether abnormalities exist in the neural regulation mechanisms of patients with comorbid Functional Constipation (FCon) and Stress Urinary Incontinence (SUI). This study employed neuroimaging to examine differences in brain activity and functional connectivity between female FCon patients with and without SUI. Materials and methods: Resting-state fMRI data were prospectively obtained from 34 female patients diagnosed with FCon comorbid with SUI (FCon-SUI), 24 female patients with FC without SUI (FCon-NSUI), and 29 Healthy Controls (HC). The study compared the Amplitude of Low-Frequency Fluctuation (ALFF) among the three groups to identify regions manifesting abnormal local spontaneous neural activity. Regions demonstrating significant ALFF variances were subsequently utilized as seeds for seed-based functional connectivity (FC) analysis. Additionally, correlations between brain functional irregularities and clinical symptoms were examined. Results: FCon-SUI and FCon-NSUI patients exhibited aberrant ALFF and FC values across various brain regions. Specifically, the FCon-SUI cohort demonstrated elevated ALFF in the right supplementary motor area (SMA) and the right middle frontal gyrus (MFG), as well as reduced ALFF in the left inferior temporal gyrus (ITG) relative to the FCon-NSUI group. In FCon-SUI, right SMA ALFF was positively correlated with KESS scores. Conclusion: Our findings highlight the unique neural activity characteristics of FCon-SUI, and provide valuable insights for monitoring brain changes in FCon-SUI patients and identifying potential therapeutic targets.