The Role of the Periaqueductal Gray Matter in Lower Urinary Tract Function.
The Role of the Periaqueductal Gray Matter in Lower Urinary Tract Function.
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DOI：
10.1007/s12035-018-1131-8
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发表时间：
2019-03
影响因子：
5.1
通讯作者：
van Koeveringe GA
中科院分区：
文献类型：
--
作者：
Zare A;Jahanshahi A;Rahnama'i MS;Schipper S;van Koeveringe GA
中脑导水管周围灰质（periaqueductal gray matter，PAG）是脑中保存最完整的一个重要结构，它调节着机体的多种重要功能，包括自主神经、行为、疼痛和排尿控制。它在膀胱生理学中具有关键作用，涉及尿液的储存和排泄。PAG具有柱状组成，并且与其位于中枢神经系统（CNS）的头侧和尾侧的组成部分具有广泛的连接。PAG作为逼尿肌和括约肌收缩的控制塔。它是进化过程中大脑高级决策中心和负责反射性排尿的低级中心之间的桥梁。谷氨酸能细胞是vlPAG中的主要操作神经元，负责从膀胱出现的信号的接收和中继到相关的脑中心。功能性成像研究使人们有可能澄清PAG在排尿和充盈阶段的活动，以及它与活体人类各种大脑中心的联系。PAG可在多种疾病中受到影响，包括多发性硬化（MS）、偏头痛、中风、韦尼克脑病和特发性正常压力脑积水，所有这些疾病在疾病的某些阶段都可能具有排尿功能障碍或失禁。这强调了该结构对于基本了解排尿和储存障碍的重要性，并使其成为诊断和治疗干预的潜在候选者。
The periaqueductal gray matter (PAG), as one of the mostly preserved evolutionary components of the brain, is an axial structure modulating various important functions of the organism, including autonomic, behavioral, pain, and micturition control. It has a critical role in urinary bladder physiology, with respect to storage and voiding of urine. The PAG has a columnar composition and has extensive connections with its cranially and caudally located components of the central nervous system (CNS). The PAG serves as the control tower of the detrusor and sphincter contractions. It serves as a bridge between the evolutionary higher decision-making brain centers and the lower centers responsible for reflexive micturition. Glutamatergic cells are the main operational neurons in the vlPAG, responsible for the reception and relay of the signals emerging from the bladder, to related brain centers. Functional imaging studies made it possible to clarify the activity of the PAG in voiding and filling phases of micturition, and its connections with various brain centers in living humans. The PAG may be affected in a wide spectrum of disorders, including multiple sclerosis (MS), migraine, stroke, Wernicke’s encephalopathy, and idiopathic normal pressure hydrocephalus, all of which may have voiding dysfunction or incontinence, in certain stages of the disease. This emphasizes the importance of this structure for the basic understanding of voiding and storage disorders and makes it a potential candidate for diagnostic and therapeutic interventions.
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