Investig Clin Urol.  2020 Mar;61(2):207-215. 10.4111/icu.2020.61.2.207.

Changes in attention variables in those who treated with anticholinergic agents for nonmonosymptomatic enuresis

• Jang G
• Im YJ
• Suh J
• Park K

• KMID: 2471077
• DOI: http://doi.org/10.4111/icu.2020.61.2.207

Abstract

PURPOSE
Brain dysfunction related to areas regarding attention and arousal may occur not only in patients with attention-deficit/hyperactivity disorder (ADHD) but also in patients with enuresis and daytime symptoms. This study aimed to investigate changes in computerized comprehensive attention tests (CATs), a psychometric test for ADHD when patients with nonmonosymptomatic enuresis (NME) were treated with anticholinergic agents.
MATERIALS AND METHODS
Thirty patients with NME featuring overactive bladder were prospectively enrolled. They were treated with 5 mg of solifenacin to control daytime symptoms. Using CATs, patients were evaluated during 12 weeks of treatment. Four subtests of attention (visual and auditory selective attention, sustained attention, and flanker tests) were measured. For each subtest, four domains (omission error, commission error, response time [RT], and standard deviation of RT) were assessed.
RESULTS
Only one domain of the flanker test was in the deficient range at baseline. The presence of urge incontinence affected follow-up results on the sustained attention tests. Treatment with anticholinergic agents did not significantly affect attention variables but changes in several variables were correlated with bladder symptoms and enuresis.
CONCLUSIONS
Minimal baseline defects in attention function were seen in patients with NME. Follow-up results for some attention variables were affected by daytime symptoms and enuresis. These results suggest that altered brain function in enuretic patients influences improvement in both attention and bladder function.

Keyword

Central nervous system; Cholinergic antagonists; Nonmonosymptomatic enuresis

MeSH Terms

Animals
Arousal
Brain
Cats
Central Nervous System
Cholinergic Antagonists*
Enuresis*
Follow-Up Studies
Humans
Prospective Studies
Psychometrics
Reaction Time
Solifenacin Succinate
Urinary Bladder
Urinary Bladder, Overactive
Urinary Incontinence, Urge
Cholinergic Antagonists
Solifenacin Succinate

Figure

• 

  Fig. 1 Schematic drawing explaining the subtests of the comprehensive attention test (CAT) and how to apply the CAT.

• 

  Fig. 2 Overall changes in the comprehensive attention test (CAT) during treatment with solifenacin for 12 weeks. Each domain of a subtest has three columns. These correspond to results at baseline, 6 weeks, and 12 weeks of treatment reading from the left. The red line marks an attention quotient (AQ) of 76, which corresponds to −1.6 SD from 100. Values below this are suggestive of deficiency of attention for a subtest. OE, omission error; CE, commission error; RT, response time; SDRT, standard deviation of response time; VSAT, visual selective attention test; ASAT, auditory selective attention test; SAT, sustained attention test.

• 

  Fig. 3 Comparison of each domain of the sustained attention test with regard to daytime incontinence. Decreasing tendency of attention quotient (AQ) with repetitive tests was seen, especially in patients with daytime incontinence. This was pronounced in commission error (CE) and standard deviation of response time (SDRT), which are related to control of impulsivity. On the other hand, an increasing trend of AQ was seen in those without daytime incontinence. OE, omission error; RT, response time; UI, urinary incontinence.

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