Brain responses to bladder filling in older women without urgency incontinence.
Brain responses to bladder filling in older women without urgency incontinence.
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DOI：
10.1002/nau.22320
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发表时间：
2013-06
影响因子：
2
通讯作者：
Griffiths D
中科院分区：
文献类型：
--
作者：
Tadic SD;Tannenbaum C;Resnick NM;Griffiths D
目的研究正常女性大脑对膀胱充盈的反应，特别是在日常生活中感觉很少或没有感觉的情况下。方法我们对正常女性受试者进行了功能磁共振成像(FMRI)研究，研究了膀胱充盈对膀胱充盈的脑部反应。结果11例女性患者年龄60~71岁，平均65岁。充盈的膀胱和强烈的排尿欲望，引发了右侧脑岛附近以及(作为一种趋势)背侧前扣带皮质和辅助运动区的众所周知的激活模式。没有明显的失活。小容量膀胱充盈引起广泛的明显失活，无明显激活。明显的失活与撤药过程中fMRI信号的增加有关，而不是与输液过程中的信号减少有关，这表明存在伪影。对整体脑血流变化的校正消除了这种感觉，并显示了明显的皮质下激活，尽管额叶或顶叶皮质没有激活。结论在膀胱功能正常的老年女性中，向已经充盈的膀胱输液可导致靠近脑岛和背侧前扣带/辅助运动复合体的强烈感觉和脑激活。在几乎空荡荡的膀胱和几乎没有感觉的情况下，在日常生活的大部分情况下，这些皮质区域没有被检测到激活，但中脑和海马区的激活可能表明无意识地监测到上升的膀胱信号。诺鲁罗。乌罗代南。2013年32：435-440。©2013 Wiley期刊，Inc.
AimsTo investigate normal brain responses to bladder filling, especially when there is little or no sensation as in much of daily life.MethodsWe performed an functional magnetic resonance imaging (fMRI) study of brain responses to bladder filling in normal female subjects, evoked by infusion and withdrawal of fluid in and out of the bladder. Using the contrast (infusion–withdrawal), we imaged brain activity at small bladder volumes with weak filling sensation and also with full bladder and strong desire to void.ResultsEleven women, average age 65 years (range: 60–71 years) were included. With full bladder and strong desire to void, filling provoked a well‐known pattern of activation near the right insula and (as a trend) in the dorsal anterior cingulate cortex and supplementary motor area. There was no significant deactivation. With small bladder volume filling provoked widespread apparent deactivation and no significant activation. Apparent deactivation was associated with increased fMRI signal during withdrawal rather than decrease during infusion, suggesting artifact. A correction for global changes in cerebral blood flow eliminated it and revealed significant subcortical activation, although none in frontal or parietal cortex.ConclusionsIn older women with normal bladder function, infusion into an already full bladder resulted in strong sensation and brain activation near the insula and in the dorsal anterior cingulate/supplementary motor complex. With near‐empty bladder and little sensation, the situation during much of daily life, these cortical areas were not detectably activated, but activation in midbrain and parahippocampal regions presumably indicated unconscious monitoring of ascending bladder signals. Neurourol. Urodynam. 32: 435–440, 2013. © 2013 Wiley Periodicals, Inc.