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BASIC AND CLINICAL RESEACH ON THE CENTRAL NERVOUS CONTROL OF MICTURITION

中枢神经控制排尿的基础与临床研究

基本信息

批准号：
02454366
负责人：
TSUCHIDA Seigi
金额：
$ 3.78万
依托单位：
DEPT. OF UROLOGY, AKITA UNIVERSITY SCHOOL OF MRDICINE
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1990
资助国家：
日本
起止时间：
1990 至 1992
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-02454366/
关键词：
micturition cerebrovascular disease nervous control urinary disturbance pontine micturition center pontine urine storage center,MRI HRP 痴呆 HRP

项目摘要

Decerebrate dogs were used to investigate the brainstem control of the micturition. Electrical stimulation (ES)(0.2msec, 50Hz, 10-50muA) in the Locus coeruleus alpha (LCalpha) evoked micturition, i.e. contraction of the urinary bladder and relaxation of the internal as well as the external urethral sphincter. ES in the Locus subcoeruleus (LSC) and the Nucleus pontis oralis (PoO) during micturition resulted in an inhibition of the bladder activity and an excitation of the external urethral sphincter. While ES in the LCalpha decreased bladder capacity, ES in the LSC and PoO increased bladder capacity. These results indicates that pontine micturition center (PMC) is located in the LCalpha and the pontine urine storage center (PUSC ) is located in the area of the LSC and the PoO. Microinjection of the drugs into the LCalpha,LSC and PoO modulated the micturition reflex. GABA in the LCalpha increased the bladder capacity while GABA in the LSC and the PoO decreased the bladder capacity. Enkep … More haline in the LCalpha and the LSC inhibited micturition, but Enkephaline in the PoO had no effect on the micturition reflex. Neuroanatomical studies using the HRP demonstrated that intimate connections between the PMC and the PUSC. HRP studies also showed that the PUSC sends and receives the fibers to and from the intermediolateral nucleus and Onuf's nucleus in the sacral spinal cord as well as the various sites of the brain.Correlation between the location of the brain lesions and the vesicourethral function were examined in the patients with cerebrovascular disease. CT and MRI were used to examine the brain lesions. Simultaneous recording of the cystometry and the external urethral sphincter EMG were performed to evaluate the vesicourethral function. Following results were obtained, (1) lesions in the frontal lobe,putamen, and thalamus resulted in a hyperactive bladder (67%,67%,60%,respectively),(2)55% of the patients with lesions in the frontal lobe had a hyperactive bladder with an incompetent urethra, (3) 60% of the patients with putaminal lesion had a normal urethral function,(4) 3 of 3 patients with bilateral lesions in the dorsolateral pontine tegmentum showed an underactive bladder.Not only basic but clinical studies indicate that the dorsolateral pontine tegmentum has an important role to regulate the micturition reflex. Less

用失智犬研究脑干对排尿的控制。电刺激（0.2msec, 50Hz, 10-50muA）蓝斑α (LCalpha)可引起排尿，即膀胱收缩和内、外尿道括约肌松弛。排尿时蓝斑下核（LSC）和口桥核（PoO）的ES导致膀胱活动抑制和尿道外括约肌兴奋。LCalpha中的ES降低了膀胱容量，LSC和PoO中的ES增加了膀胱容量。这些结果表明，脑桥排尿中心（PMC）位于LCalpha，脑桥尿液储存中心（PUSC）位于LSC和PoO区域。将药物微量注射到LCalpha、LSC和PoO中，可调节排尿反射。LCalpha中的GABA增加了膀胱容量，而LSC和PoO中的GABA降低了膀胱容量。在LCalpha和LSC中添加更多的盐可以抑制排尿，而在PoO中添加更多的Enkephaline对排尿反射没有影响。使用HRP的神经解剖学研究表明PMC和PUSC之间有密切的联系。HRP研究还表明，PUSC在骶脊髓的中外侧核和Onuf核以及大脑的各个部位之间发送和接收纤维。探讨脑血管病患者脑病变部位与膀胱输尿管功能的相关性。采用CT和MRI检查脑病变。同时记录膀胱造影和外尿道括约肌肌电图，评价膀胱尿道功能。结果显示：(1)额叶、壳核和丘脑病变导致膀胱过度活动（分别为67%、67%、60%）；(2)额叶病变患者中55%的患者膀胱过度活动伴尿道功能不全；(3)壳核病变患者中60%的患者尿道功能正常；(4)3例双侧脑桥背外侧被病变患者中3例膀胱活动不足。无论是基础研究还是临床研究都表明，脑桥背外侧被盖对排尿反射具有重要的调节作用。少