Measurement of Neuroexcitation during Bladder Filling: A Novel Metric for Overactive Bladder Phenotyping

项目总结： 膀胱过度活动症(OAB)主要由尿急症状定义，是一种多因素的疾病， 影响了超过25%的人口。因为紧迫感是大脑对多因素事件的解释， 了解膀胱充盈过程中大脑活动的区域是很重要的。最近，有一种 越来越多的研究使用功能磁共振成像(FMRI)来确定与以下各项相关的大脑区域和通路 OAB。然而，功能磁共振成像是昂贵的，耗时的，并且需要高度专业化的专家。因此，一个关键的 研究目标是开发基于办公室的神经成像技术来改进OAB表型。 我们的多学科研究小组结合了泌尿学、工程学和神经成像的专业知识，已经做出了 用于OAB评估的基于办公室的新技术的开发进展。我们创建了一个实时 在膀胱充盈过程中使用的感觉计。我们还开发了一种新的功能性脑NIRS(FNIRS)协议 这显示了局部的皮质神经兴奋区域对膀胱充盈的反应。我们的假设是fNIR 可用于识别代表新表型亚型的不同OAB模式。 我们将在两个目标上检验我们的假设。在第一个目标中，我们将用fnirs识别神经兴奋的模式。 在正常男性和女性OAB患者的自然膀胱充盈过程中，使用我们建立的三次充盈水化方案。 然后我们将使用这些信息来评估患有OAB的年龄匹配的女性。第二个目标将比较 OAB患者自然膀胱充盈过程中fNIRS和fMRI的神经兴奋模式。 这项提案的成功完成将使用fNIRS创建新的基于办公室的神经成像技术， 与我们已建立的感觉测量仪和补水方案相结合，最终可用于改善 OAB的表型在未来的研究中。这项研究的数据将用于后续的多PI R01提案 在患有不同形式排尿功能障碍的更大参与者群体中测试我们的fNIRS技术 研究OAB治疗对感觉和神经成像通路的急性和慢性影响。

Project Summary: Overactive Bladder (OAB), defined mainly by the symptom of urinary urgency, is a multifactorial condition, affecting more than 25% of the population. Because urgency is the brain's interpretation of multifactorial events, it is important to understand areas of brain activation that occur during bladder filling. Recently, there has been a growing body of research using functional MRI (fMRI) to identify brain regions and pathways associated with OAB. However, fMRI is expensive, time-consuming, and requires highly-specialized experts. Thus, a critical research objective is the development of office-based neuroimaging technologies to improve OAB phenotyping. Our multi-disciplinary research group combining urology, engineering, and neuroimaging expertise has made advances in the development of novel office-based technologies for OAB evaluation. We created a real-time Sensation Meter used during bladder filling. We also developed a novel functional Brain NIRS (fNIRS) protocol that shows localized regions of cortical neuroexcitation in response to bladder filling. Our hypothesis is that fNIRS can be used to identify different patterns of OAB representing new phenotypic subtypes. We will test our hypothesis in two aims. In the first aim, we will identify patterns of neuroexcitation with fNIRS during natural bladder filling in normal men and women with OAB using our established 3-fill hydration protocol. We will then use this information to evaluate age-matched women with OAB. The second aim will compare patterns of neuroexcitation with fNIRS and fMRI during natural bladder filling in women with OAB. Successful completion of this proposal will create new office-based neuroimaging technology using fNIRS that, in combination with our established sensation meter and hydration protocols, can ultimately be used for improved phenotyping of OAB in future studies. The data from this study will be used in subsequent multi-PI R01 proposals to test our fNIRS technology on larger participant groups with varying forms of voiding dysfunction and also to study the acute and chronic effects of OAB treatments on sensation and neuroimaging pathways.