Brain responses to changes in bladder volume and urge to void in healthy men
Brain responses to changes in bladder volume and urge to void in healthy men
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DOI：
10.1093/brain/124.2.369
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发表时间：
2001-02-01
期刊：
影响因子：
14.5
通讯作者：
Fowler, CJ
中科院分区：
文献类型：
--
作者：
Athwal, BS;Berkley, KJ;Fowler, CJ
了解膀胱容量的变化和排空冲动如何影响大脑活动对于理解控制尿失禁和排尿的大脑机制非常重要。本研究使用PET评估了与不同水平的被动膀胱充盈和排空冲动相关的大脑活动。11名年龄19-54岁的健康男性受试者（3名左撇子和8名右撇子）导尿并沿尿道逆行填充膀胱，在6个膀胱容量的每一个重复两次期间获得12次PET扫描，受试者在每次扫描前后评估他们对排尿冲动的感知。在导水管周围灰质（PAG）、中线笔、扣带中部皮层和双侧额叶区域，与膀胱体积增加相关的大脑活动增加，在扣带皮层的另一部分、运动前皮层和下丘脑中，与减少排空冲动相关的大脑活动增加。两种激活模式都主要是双侧对称的，没有一种影响可以归因于导管的存在。然而，在一些受试者中，主要是那些报告来自尿道导管的侵入性感觉的受试者，在充盈量和冲动之间存在差异，因此他们报告的高冲动与低体积之间存在差异，随着这种“不匹配”的减少，体感皮层的双侧激活增加。我们的研究结果支持了PAG接收膀胱充盈信息并将此信息传递到控制膀胱储存的区域的假设。我们的研究结果还表明，参与调节排空冲动感知的大脑区域网络与与膀胱充盈相关的网络不同。
Knowledge of how changes in bladder volume and the urge to void affect brain activity is important for understanding brain mechanisms that control urinary continence and micturition, This study used PET to evaluate brain activity associated with different levels of passive bladder filling and the urge to void. Eleven healthy male subjects (three left- and eight right-handed) aged 19-54 years were catheterized and the bladder filled retrogradely per urethra, Twelve PET scans were obtained during two repetitions of each of six bladder volumes, with the subjects rating their perception of urge to void prior to and after each scan. Increased brain activity related to increasing bladder volume was seen in the periaqueductal grey matter (PAG), in the midline pens, in the mid-cingulate cortex and bilaterally in the frontal lobe area, Increased brain activity relating to decreased urge to void was seen in a different portion of the cingulate cortex, in premotor cortex and in the hypothalamus. Both activation patterns were predominantly bilaterally symmetric and none of the effects could be attributed to the presence of the catheter, However, in some subjects, mostly those reporting intrusive sensations from the urethral catheter, there was a discrepancy between filling volume and urge so that they reported high urge with low volumes, As this 'mismatch' decreased, activation increased bilaterally in the somatosensory cortex. Our findings support the hypothesis that the PAG receives information about bladder fullness and relays this information to areas invoked in the control of bladder storage. Our results also show that the network of brain regions involved in modulating the perception of the urge to void is distinct from that associated with the appreciation of bladder fullness.