Age-dependent heterogeneity in brain networks and interhemispheric synchrony in overactive bladder syndrome

Overactive bladder (OAB) may involve age-dependent alterations in brain networks, but whether age modifies structural network organization and interhemispheric synchrony remains unclear. In this cross-sectional study, 111 participants with OAB and 114 healthy controls were classified as young (≤ 40 years), middle-aged (41–65 years), and older (> 65 years). The primary hypothesis was tested using diagnosis-by-age-stratum interaction models in global structural network topology and whole-brain voxelwise degree centrality (DC) and voxel-mirrored homotopic connectivity (VMHC). Complementary continuous-age models were supportive, whereas seed-based connectivity and imaging–clinical correlations were exploratory. Significant interactions were observed for clustering coefficient (Cp), right supramarginal gyrus DC, and left inferior parietal lobule VMHC. Cp and right supramarginal gyrus DC were higher in middle-aged but lower in older participants with OAB than in age-matched controls; older participants also showed reduced left inferior parietal lobule VMHC and left IPL–right SMG functional connectivity. Parietal imaging measures were associated with greater clinical burden, particularly in older adults. Continuous-age analyses supported the DC and VMHC findings but not Cp. These results indicate age-dependent neuroimaging heterogeneity in OAB and suggest that age should be considered when characterizing brain–bladder network alterations.