Voluntary pelvic floor muscle control - An fMRI study
Voluntary pelvic floor muscle control - An fMRI study
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DOI：
10.1016/j.neuroimage.2006.02.012
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发表时间：
2006-07-15
期刊：
影响因子：
5.7
通讯作者：
Dechent, P.
中科院分区：
文献类型：
--
作者：
Seseke, S.;Baudewig, J.;Dechent, P.
膀胱储存和定期排出尿液是由中枢通路控制的，并被组织成简单的开关电路。一些关于排尿控制方面的报告已经确定了脑干中的不同区域，如脑桥排尿中心（PMC）和导水管周围灰质（PAG），以及小脑，基底神经节，边缘系统和皮质区，它们组织成广泛的网络。本研究的重点是这些特定的大脑区域在骨盆底肌肉控制的参与。在3T下对11名因膀胱充盈而有排尿冲动的健康女性进行功能性磁共振成像（fMRI），指导她们通过释放来模仿排尿或通过收缩骨盆底肌肉来模仿排尿中断。在实验过程中，没有一个受试者能够开始排尿，可能是由于不方便的情况下产生的潜意识抑制。骨盆底肌肉的松弛和收缩引起了包括额叶皮层、感觉运动皮层、小脑和基底神经节在内的强而相似的激活模式。此外，在PMC和PAG中确定了良好的局部激活。据我们所知，这是第一个使用功能磁共振成像来证明这些脑干结构中与排尿相关的活动的研究。所提出的方法被证明是表征广泛的中枢网络在骨盆底肌肉控制。因此，在排尿功能障碍患者中，功能磁共振成像将有助于阐明个体障碍水平。(c)2006年爱思唯尔公司All rights reserved.
Storage and periodic expulsion of urine by the bladder are controlled by central pathways and organized as simple on-off switching circuits. Several reports concerning aspects of micturition control have identified distinct regions in the brainstem, like the pontine micturition center (PMC) and the periaqueductal gray (PAG), as well as the cerebellum, basal ganglia, limbic system, and cortical areas that are organized in a widespread network. The present study focused on the involvement of these specific brain regions in pelvic floor muscle control. Functional magnetic resonance imaging (fMRI) was performed at 3T in 11 healthy women with urge to void due to a filled bladder, who were instructed to either imitate voiding by releasing or to imitate interruption of voiding by contracting pelvic floor muscles. None of the subjects was able to start voiding during the experiments, presumably due to subconscious restraint resulting from the inconvenient situation. Relaxation and contraction of pelvic floor muscles induced strong and similar activation patterns including frontal cortex, sensory-motor cortex, cerebellum, and basal ganglia. Furthermore, well-localized activations in the PMC and the PAG were identified. To our knowledge, this is the first study using fMRI to demonstrate micturition-related activity in these brainstem structures. The presented approach proved to characterize the widespread central network in pelvic floor muscle control. Thus, in patients with voiding dysfunction, fMRI will be useful to elucidate the individual disturbance level. (c) 2006 Elsevier Inc. All rights reserved.