Brain activation measurement by NIRS in response to bladder behavior

本研究的目的是探讨正常膀胱行为过程中额部排尿区的脑活动。5名对照组受试者(1名男性和4名女性，平均年龄61岁[38-70])和4名有逼尿肌过度活动的受试者(全部为男性，平均年龄55岁[33-65])参加了研究。我们使用功能性近红外光谱(FNIRS)实时测量了前排尿区氧合血红蛋白浓度(oxy-Hb)的变化，以响应准自然、持续的膀胱充盈和坐位排尿。对照组有如下结果：1)首次感觉出现前，oxy-Hb略有升高；2)在膀胱充盈过程中，oxy-Hb持续升高，直到排尿开始；3)排尿后oxy-Hb持续下降；4)不能排尿的受试者，尝试排尿后oxy-Hb也下降；5)激活的区域是双侧额叶外侧区，尤其是Brodmann区8、10和46。逼尿肌过度活动组，6)首次感觉前氧合血红蛋白含量极少升高，额叶皮质激活较弱，7)逼尿肌过度活动出现时，额叶皮质fNIRS脑活动无明显变化，其余结果与对照组基本一致。这项研究表明，利用fNIRS技术，在自然充盈和排尿过程中，额部排尿区被激活。我们也能够显示在服用抗胆碱药物后额叶前部活动减少的正常化。

Aim of this study is to explore brain activity in the frontal micturition area during natural bladder behaviour. Five control subjects (one man and four women; mean age 61 years [38-70]) and four subjects with detrusor overactivity(all men; mean age 55 years [33-65]) were enrolled in the study. We performed real-time measurements of oxyhemoglobin concentration (oxy-Hb) changes in the frontal micturition area using functional near-infrared spectroscopy (fNIRS) in response to quasi-natural, continuous bladder filling and voiding in a sitting position. In the control group the following results were obtained: 1) a slight increase ofoxy-Hb before first sensation occurred, 2) there was a continuous increase of oxy-Hb during bladder filling to the point just after voiding began, 3) there was a continuous decrease of oxy-Hb after voiding, 4) in subjects who were unable to urinate, oxy-Hb also decreased after attempting to void, and 5) the area activated was the bilateral lateral prefrontal area, particularly Brodmann’s areas 8, 10 and 46. In the detrusor overactivity group, 6) an increase of oxy-Hb before first sensation was rare and frontal cortical activation was weak, 7) at the moment detrusor overactivity appeared, fNIRS brain activity in the frontal cortex did not change significantly; and otherwise the results were almost the same as those inthe control group. This study shows that the frontal micturition area is activated during natural bladder filling and voiding using fNIRS. We were also able to show normalization of decreased prefrontal activity after administration of anticholinergics.