Abnormal connections in the supraspinal bladder control network in women with urge urinary incontinence
Abnormal connections in the supraspinal bladder control network in women with urge urinary incontinence
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DOI：
10.1016/j.neuroimage.2007.10.059
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发表时间：
2008-02-15
期刊：
影响因子：
5.7
通讯作者：
Resnick, Neil M.
中科院分区：
文献类型：
--
作者：
Tadic, Stasa D.;Griffiths, Derek;Resnick, Neil M.
控制膀胱行为的脊髓上网络区域是众所周知的，但对其相互关系却知之甚少。我们测试了利用生理生理相互作用来探索网络的有效连接并寻找与疾病相关的连接差异的可行性。这是对 26-85 岁女性的功能磁共振成像数据进行的二次分析，其中 11 名女性患有急迫性尿失禁，10 名女性膀胱功能正常。在每个受试者中，在膀胱充盈且膀胱感觉强烈（无逼尿肌过度活动）期间，同时反复向膀胱内注入和排出少量液体时，获得 fMRI BOLD 图像。感兴趣的区域包括右岛叶 (RI) 和前扣带回陀螺 (ACG)，两者始终参与膀胱控制。通过功能磁共振成像信号与 RI x ACG 相互作用之间的显着相关性来识别与它们有效连接的其他区域。在正常受试者中，许多涉及膀胱控制的区域与 RI/ACG 有效相关，包括额颞叶和感觉运动皮层、前脑、中脑和脑桥区域。与 RIxACG 的相关性几乎一致为正，这可能表明主要是抑制性联系。在急迫性尿失禁受试者中，有效连接转移到顶颞复合体，而相关性的符号主要为负，这可能与试图维持膀胱控制的旁路兴奋（募集）一致。因此，生理生理学相互作用产生了有关膀胱控制网络的连通性及其疾病变化的潜在重要信息。 (C) 2007 Elsevier Inc. 保留所有权利。
The regions of the supraspinal network that controls urinary bladder behavior are well known, but little is known about their interconnections. We tested the feasibility of using physiophysiological interaction to explore the effective connections of the network and to seek disease-related differences in connectivity. This was a secondary analysis of fMRI data obtained from women aged 26-85 years, 11 with urge urinary incontinence and 10 with normal bladder function. In each subject, fMRI BOLD images were obtained during a period with full bladder and strong bladder sensation (without detrusor overactivity) while repeatedly infusing and withdrawing a small amount of liquid in and out of the bladder. Regions of interest included right insula (RI) and anterior cingulate gyros (ACG), both consistently involved in bladder control. Other regions effectively connected to them were identified by significant correlation between their fMRI signal and the interaction RI x ACG. Among normal subjects, many regions involved in bladder control were effectively connected with RI/ACG, including frontotemporal and sensorimotor cortex, forebrain, midbrain and pontine regions. The sign of the correlation with RIxACG was near-uniformly positive, perhaps suggesting mainly inhibitory connections. Among urge-incontinent subjects, the effective connectivity was shifted to a parieto-temporal complex, while the sign of the correlation was predominantly negative, perhaps consistent with excitation (recruitment) of accessory pathways in an attempt to maintain bladder control. Thus, physiophysiological interaction yields potentially important information about the connectivity of the bladder control network and its changes in disease. (C) 2007 Elsevier Inc. All rights reserved.