A Preliminary Report on the Use of Functional Magnetic Resonance Imaging with Simultaneous Urodynamics to Record Brain Activity During Micturition
A Preliminary Report on the Use of Functional Magnetic Resonance Imaging with Simultaneous Urodynamics to Record Brain Activity During Micturition
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DOI：
10.1016/j.juro.2012.04.004
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发表时间：
2012-08-01
影响因子：
6.6
通讯作者：
Zvara, Peter
中科院分区：
文献类型：
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作者：
Krhut, Jan;Tintera, Jaroslav;Zvara, Peter
目的：应用功能磁共振成像技术同时记录膀胱缓慢充盈和排尿过程中的尿动力学特性，绘制排尿时的脑活动图。材料和方法：对12名20~68岁健康女性志愿者进行研究。八名受试者可以在仰卧时小便。这些受试者中有6人获得了有意义的数据。在膀胱充盈和排尿过程中连续记录脑电活动。结果：通过分组统计，我们发现在排尿过程中，大脑活动集中在海马旁回、扣带回前回、颞下回和额叶下回。在个体水平上，我们还观察到桥上区、丘脑和后扣带的激活。在无法消除大脑活动的受试者中，额叶和后扣带回有记录，但脑桥、丘脑或前扣带回没有记录。在5名受试者中，当患者报告有强烈的排尿欲望时，我们确定了充盈阶段末期大脑活动的相关模式。结论：这一新的方案允许定位排尿期间活跃的大脑结构。数据表明，还需要进行额外的验证研究。未来的研究将测试修改，包括更详细地监测膀胱感觉，根据年龄和性别对受试者进行分层，并通过增加受试者和单个受试者记录的排尿次数来增加数据点的数量。
Purpose: We mapped brain activity during micturition using functional magnetic resonance imaging with simultaneous recording of urodynamic properties during slow bladder filling and micturition.Materials and Methods: We evaluated 12 healthy female volunteers 20 to 68 years old. Eight subjects could urinate while supine. Meaningful data were obtained on 6 of these subjects. Brain activity was recorded continuously during bladder filling and micturition. Functional magnetic resonance imaging measurements made during the micturition phase were used for the final analysis.Results: Using group statistics we identified clusters of brain activity in the parahippocampal gyrus, anterior cingulate gyrus, inferior temporal gyrus and inferior frontal gyrus during micturition. At the individual level we also observed activation in the upper pontine region, thalamus and posterior cingulum. In subjects unable to void brain activation was documented in the frontal lobe and posterior cingulate gyrus but not in the pons, thalamus or anterior cingulate gyrus. In 5 subjects we identified a relevant pattern of brain activity during the terminal portion of the filling phase when the patient reported a strong desire to urinate.Conclusions: This new protocol allows for the localization of brain structures that are active during micturition. Data suggest that additional validation studies are needed. Future studies will test modifications that include more detailed monitoring of bladder sensation, stratifying subjects based on age and gender, and increasing the number of data points by adding subjects and the number of micturitions recorded in a single subject.