Brain activation measurement by NIRS in response to bladder behavior

本研究的目的是探讨在自然膀胱行为过程中，额叶排尿区的脑活动。5名对照受试者（1名男性和4名女性;平均年龄61岁[38-70]）和4名逼尿肌过度活动受试者（均为男性;平均年龄55岁[33-65]）入组研究。我们使用功能性近红外光谱（fNIRS）对坐位准自然连续膀胱充盈和排尿进行了额叶排尿区氧合血红蛋白浓度（oxy-Hb）变化的实时测量。在对照组中，获得了以下结果：1）在第一次感觉发生之前氧合血红蛋白轻微增加，2）在膀胱充盈期间氧合血红蛋白持续增加，直到排尿开始后，3）排尿后氧合血红蛋白持续减少，4）在不能排尿的受试者中，氧合血红蛋白在尝试排尿后也减少，（5）激活区为双侧前额叶外侧区，尤其是Brodmann第8、10和46区。逼尿肌过度活动组在第一次感觉前氧合血红蛋白的增加很少，额叶皮层的激活较弱;逼尿肌过度活动出现时，额叶皮层的fNIRS脑活动无明显变化，其余与对照组基本相同。这项研究表明，使用fNIRS，在膀胱自然充盈和排尿期间，额叶排尿区被激活。我们也能够显示正常化减少前额叶活动后，管理抗胆碱能药物。

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.