Functional Magnetic Resonance Imaging during Urodynamic Testing Identifies Brain Structures Initiating Micturition

Michael Shy; Steve Fung; Timothy B Boone; Christof Karmonik; Sophie G Fletcher; Rose Khavari

doi:10.1016/j.juro.2014.04.090

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Functional Magnetic Resonance Imaging during Urodynamic Testing Identifies Brain Structures Initiating Micturition

Journal article

Open access

Peer reviewed

Functional Magnetic Resonance Imaging during Urodynamic Testing Identifies Brain Structures Initiating Micturition

Michael Shy, Steve Fung, Timothy B Boone, Christof Karmonik, Sophie G Fletcher and Rose Khavari

The Journal of urology, Vol.192(4), pp.1149-1154

10/2014

DOI: 10.1016/j.juro.2014.04.090

PMCID: PMC5485249

PMID: 24769029

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Abstract

Normal voiding in neurologically intact patients is triggered by the release of tonic inhibition from suprapontine centers, allowing the pontine micturition center to trigger the voiding reflex. Supraspinal mechanisms of voluntary voiding in humans are just beginning to be described via functional neuroimaging. We further elucidated brain activity processes during voiding using functional magnetic resonance imaging in normal females to gain better understanding of normal voiding as well as changes that may occur in voiding dysfunction. We screened 13 healthy premenopausal female volunteers using baseline clinic urodynamics to document normal voiding parameters. We then recorded brain activity via functional magnetic resonance imaging and simultaneous urodynamics, including the pressure flow voiding phase. After motion correction of functional magnetic resonance images we performed activation and connectivity analyses in 10 subjects. Group analysis revealed consistent activation areas, including regions for motor control (cerebellum, thalamus, caudate, lentiform nucleus, red nucleus, supplementary motor area and post-central gyrus), emotion (anterior/posterior cingulate gyrus and insula), executive function (left superior frontal gyrus) and a focal region in the pons. Connectivity analysis demonstrated strong interconnectivity of the pontine micturition center with many short-range and long-range cortical clusters. Our study is one of the first reports of brain activation centers associated with micturition initiation in normal healthy females. Results show activation of a brain network consisting of regions for motor control, executive function and emotion processing. Further studies are planned to create and validate a model of brain activity during normal voiding in women.

urinary tract

magnetic resonance imaging

brain

urination

central nervous system

Details

Title: Subtitle: Functional Magnetic Resonance Imaging during Urodynamic Testing Identifies Brain Structures Initiating Micturition
Creators: Michael Shy - Scott Department of Urology, Baylor College of Medicine, Houston, Texas
Steve Fung - Radiology Department, Houston Methodist Research Institute, Houston, Texas
Timothy B Boone - Department of Urology, Houston Methodist Hospital, Houston, Texas
Christof Karmonik - Radiology Department, Houston Methodist Research Institute, Houston, Texas
Sophie G Fletcher - Department of Urology, Houston Methodist Hospital, Houston, Texas
Rose Khavari - Department of Urology, Houston Methodist Hospital, Houston, Texas
Resource Type: Journal article
Publication Details: The Journal of urology, Vol.192(4), pp.1149-1154
DOI: 10.1016/j.juro.2014.04.090
PMID: 24769029
PMCID: PMC5485249
NLM abbreviation: J Urol
ISSN: 0022-5347
eISSN: 1527-3792
Publisher: Elsevier Inc
Language: English
Date published: 10/2014
Academic Unit: Neurology; Molecular Physiology and Biophysics; Stead Family Department of Pediatrics; Iowa Neuroscience Institute
Record Identifier: 9984020500402771

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