SUPRAPONTINE CONTROL OF MICTURITION

尿液的储存和定期释放受到以下控制 中枢神经系统(CNS)的几个级别，包括 腰骶髓、桥头端、下丘脑、皮质下 核团和大脑皮层。各种证据表明， 排尿的兴奋性副交感神经成分 反射依赖于起源于脊髓上的一条通路。 脑桥(“脑桥排尿中心”-PMC)和发送 下行纤维通向骶髓。最近，一个 在控制中牵涉到了脑桥吻侧区域 输尿管外括约肌(EUS)的其他证据 提示PMC可能调节或协调PMC的活动 EUS。众所周知，对中枢神经系统的损害 脑桥区的尾侧会引起严重的尿潴留 通常伴有膀胱-括约肌协同失调。临床研究表明 还表明对桥上或桥上结构的破坏 无论是由于中风，肿瘤，创伤，还是中央的疾病 神经系统(CNS)在某些情况下可导致过度活跃 膀胱紧迫症和大小便失禁等情况 膀胱活动减退伴尿滞留。 本提案中概述的研究旨在 利用现代神经解剖学提供详细的分析， 神经药理学和神经生理学技术， 桥和桥上的结构，它们调节着 排尿反射通路。 这项拟议研究的目的是：(1)确定 可能的神经递质及其激动剂和 拮抗剂，当直接注射到PMC时反射 膀胱和括约肌活动。(2)确定分布 侧脑桥中调节EUS活动的神经元。(3) 确定从PMC到EUS“中心”的可能输入 来自中枢神经的桥上区域。(4)找出可能的 调节输入到EUS中心的神经递质。(5) 用特定的神经递质拮抗剂阻断或用 激动剂，上述输入。(6)考核单项 PMC和EUS“中心”神经元使用5个支架 微电极和确定所用药物的效果 以离子电泳法连接到这些神经元。从这一过程中获得的信息 研究不仅将提供更完整的接线图 排尿途径，但也可能暗示有可能 排尿行为的药理修饰。

The storage and periodic release of urine is controlled from several levels of the central nervous system (CNS) including the lumbosacral spinal cord, rostral pons, hypothalamus, subcortical nuclei, and the cerebral cortex. Various evidence indicates that the excitatory parasympathetic component of the micturition reflex is dependent upon a supraspinal pathway originating in the rostral pons ("pontine micturition center"-PMC) and sending descending fibers to the sacral spinal cord. More recently a lateral area of the rostral pons has been implicated in the control of the external uretheral sphincter (EUS) additional evidence suggests that the PMC may modulate or coordinate the activity of the EUS. It is known that damage to the central nervous system caudal to this pontine area causes profound urinary retention often with bladder-sphincter dyssynergia. Clinical studies have also shown that damage to pontine or suprapontine structures whether due to stroke, tumors, trauma, or disease of the central nervous system (CNS) can cause in some instances a hyperactive bladder with urgency and incontinence in and other instances a hypoactive bladder with urinary retention. The studies outlined in the present proposal are designed to provide a detailed analysis, using modern neuroanatomical, neuropharmacological and neurophysiological techniques, of pontine and suprapontine structures which modulate the micturition reflex pathway. The aims of this proposed research are: (1) To determine the effects of putative neurotransmitters and their agonist and antagonists, when injected directly into the PMC on reflex bladder and sphincter activity. (2) To determine the distribution of neurons in the lateral pons which modulate EUS activity. (3) To determine the possible inputs to EUS 'center' from PMC and from suprapontine areas of the CNS. (4) To identify possible neurotransmitters which mediate input to the EUS 'center. (5) To block with specific neurotransmitter antagonists or mimic with agonists the inputs mentioned above. (6) To examine single neurons of the PMC and EUS 'center' using five barelled microelectrodes and to determine the effects of drugs applied iontophoretically to these neurons. The information gained in this study will not only provide a much more complete wiring diagram for the micturition pathway but may also suggest possible pharmacological modifications of the act of micturition.