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.

This study was supported by grants from the National Natural Science Foundation of China (no. 82370777 and 82570904 to N.F.), Major scientific research Project of the Health Commission of Jiangsu Province (no. ZD2021002 to N.F.), The Wuxi City Science and Technology Innovation and Entrepreneurship Fund “Taihu Light” Science and Technology Research Program (no. Y20242111 to Y.H.), and Scientific Research Project of Jiangsu Provincial Health Commission (no.

Jiangnan University Medical Center, 68 Zhongshan Road, Wuxi, 214002, China Ye Hua, Yuwei Zhang, Kaiyuan Gu, Feng Lu, Jia Xuª, Yuhua Zhou, Huikai Miao, Yifan Sun, Yao Chen & Ninghan Feng Wuxi School of Medicine, Jiangnan University, Wuxi, China Ye Hua, Siyi Fu, Jiayu Gu & Ninghan Feng Nanjing Medical University, Nanjing, China Medical School of Nantong University, Nantong, China Department of Pharmacology, Nanjing Medical University, 101 Longmian Road, Nanjing, 211166, China Correspondence to Yi Fan or Ninghan Feng. The authors declare no competing interests. The content of this manuscript has not been published elsewhere.

All authors have reviewed and approved the manuscript for submission. This study does not involve any identifying images, personal or clinical details of participants that would compromise anonymity. The study was approved by the Jiangnan University Medical Center Ethics Committee (2024 Y 26) and registered (ISRCTN11583354).