Brain activation during detrusor overactivity in patients with Parkinson's disease: A positron emission tomography study
Brain activation during detrusor overactivity in patients with Parkinson's disease: A positron emission tomography study
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DOI：
10.1016/s0022-5347(05)00324-1
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发表时间：
2006-03-01
影响因子：
6.6
通讯作者：
Nonomura, K
中科院分区：
文献类型：
--
作者：
Kitta, T;Kakizaki, H;Nonomura, K
目的：帕金森病患者常出现尿急、尿频、尿失禁等储尿症状，这些症状是逼尿肌过度活动所致。然而，在这种疾病中，引起逼尿肌过度活动的机制知之甚少。我们以前研究了人类大脑的反应，膀胱充盈健康男性志愿者使用正电子发射断层扫描。我们假设，大脑激活模式在膀胱充盈的反应将是不同的帕金森病patients with Parkinson's disease.Materials and Methods：9例男性帕金森病患者通过尿道插管膀胱充盈和膀胱内压力监测。我们进行了正电子发射断层扫描，包括任务1和2。对于任务1，通过导尿管保持膀胱排空。对于任务2，滴入室温水用于膀胱充盈，直到逼尿肌过度活动开始。任务2的数据采集在逼尿肌过度活动期间完成。每次扫描的数据在计算机上求和，并使用统计参数映射程序进行进一步分析。结果：逼尿肌过度活动时，中脑导水管周围有明显的脑激活。灰质、辅助运动区、小脑蚓部、丘脑、壳核和丘脑。在小脑中发现了最显著的激活。脑桥没有激活逼尿肌overactivity.Conclusions：在脑激活网站的改变，膀胱充盈可能与帕金森病患者的逼尿肌过度活动的病理生理。
Purpose: Patients with Parkinson's disease often have urine storage symptoms, such as urinary urgency, frequency and incontinence, which are induced by detrusor overactivity. However, little is known of the mechanisms inducing detrusor overactivity in this disease. We have previously examined the human brain response to bladder filling in healthy male volunteers using positron emission tomography. We hypothesized that brain activation patterns in response to bladder filling would be different in patients with Parkinson's disease.Materials and Methods: Nine male patients with Parkinson's disease were catheterized via the urethra for bladder filling and intravesical pressure monitoring. We performed positron emission tomography, consisting of tasks 1 and 2. For task 1 the bladder was maintained empty via the urethral catheter. For task 2 room temperature water was dripped for bladder filling until the onset of detrusor overactivity. Data acquisition for task 2 was done during detrusor overactivity. Data on each scan were summed on a computer and further analyzed using a statistical parametric mapping procedure. Results: Significant brain activation during detrusor overactivity was found in the periaqueductal. gray, supplementary motor area, cerebellar vermis, insula, putamen and thalamus. The most prominent activation was found in the cerebellum. The pons was not activated during detrusor overactivity.Conclusions: Alteration in brain activation sites in response to bladder filling may be related to the pathophysiology of detrusor overactivity in patients with Parkinson's disease.