Brain activation during micturition in women
Brain activation during micturition in women
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DOI：
10.1093/brain/121.11.2033
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发表时间：
1998-11-01
期刊：
影响因子：
14.5
通讯作者：
Holstege, G
中科院分区：
文献类型：
--
作者：
Blok, BFM;Sturms, LM;Holstege, G
在猫身上的实验导致了一个关于中枢神经系统如何控制排尿的概念。在之前的一项研究中，这一概念在一项针对男性志愿者的PET研究中进行了测试，结果表明，特定的脑干和前脑区域在排尿过程中被激活，不幸的是，这项研究没有涉及女性，因为这样的结果对于理解急迫性尿失禁非常重要，这种情况在女性比男性更常见。因此，对18名惯用右手的女性进行了类似的研究，她们在以下四种情况下进行了扫描：(I)排尿前15分钟(禁尿)；(Ii)排尿期间；(Iii)排尿后15分钟；(Iv)排尿后30分钟，在18名志愿者中，10人在扫描过程中能够排尿，8人尽管努力尝试，但仍无法排尿。排尿与右侧桥脑背侧被盖和右侧额下回的血流显著增加有关，而右侧扣带回前区的血流在扣留尿时明显减少。在扫描过程中不能排尿的8名志愿者在右侧背侧没有显示出明显的局部脑血流量增加，但在猫的右侧脑桥腹侧被盖显示出明显的增加，在猫身上，这个区域控制着盆底的运动神经元。在同一排尿不成功组，右额下回血流也增加，所有18名志愿者在排尿前禁尿期间，右侧扣带前回血流减少。结果表明，在女性和男性的皮肤中，负责控制排尿的脑桥被盖中存在着相同的特定核。结果还表明，右侧皮质和桥脑排尿部位比左侧更为活跃。
Experiments in the cat have led to a concept of how the CNS controls micturition. In a previous study this concept was tested in a PET study in male volunteers, It was demonstrated that specific brainstem and forebrain areas are activated during micturition, It was unfortunate that this study did not involve women, because such results are important for understanding urge incontinence, which occurs more frequently in women than in men. Therefore, a similar study was done in 18 right-handed women, who were scanned during the following four conditions: (i) 15 min prior to micturition (urine withholding); (ii) during micturition; (iii) 15 min after micturition; and (iv) 30 min after micturition, Of the 18 volunteers, 10 were able to micturate during scanning and eight were not, despite trying vigorously. Micturition appeared to be associated with significantly increased blood flow in the right dorsal pontine tegmentum and the right inferior frontal gyrus, Decreased blood flow was found in the right anterior cingulate gyrus during urine withholding. The eight volunteers who were not able to micturate during scanning did not show significantly increased regional cerebral blood flow in the right dorsal, but did so in the right ventral pontine tegmentum, In the cat this region controls the motor neurons of the pelvic floor. In the same unsuccessful micturition group, increased blood flow was also found in the right inferior frontal gyrus, In all 18 volunteers, decreased blood flow in the right anterior cingulate gyrus was found during the period when they had to withhold their urine prior to the micturition condition. The results suggest that in women rind in men the same specific nuclei exist in the pontine tegmentum responsible for the control of micturition. The results also indicate that the cortical and pontine micturition sites are more active on the right than on the left side.