Nardos Rahel, Gregory William Thomas, Krisky Christine, Newell Amanda, Nardos Binyam, Schlaggar Bradley, Fair Damien A
Oregon Health and Science University, Portland, Oregon; Kaiser Permanente, Clackamas, Oregon.
Neurourol Urodyn. 2014 Jun;33(5):493-501. doi: 10.1002/nau.22458. Epub 2013 Jul 3.
This aim of this study is to identify the brain mechanisms involved in bladder control.
We used fMRI to identify brain regions that are activated during bladder filling. We then used resting state connectivity fMRI (rs-fcMRI) to assess functional connectivity of regions identified by fMRI with the rest of the brain as the bladder is filled to capacity.
Female participants (n = 20) were between ages 40 and 64 with no significant history of symptomatic urinary incontinence. Main effect of time (MET) fMRI analysis resulted in 20 regions of interest (ROIs) that have significant change in BOLD signal (z = 3.25, P <0.05) over the course of subtle bladder filling and emptying regardless of full versus empty bladder state. Bladder-state by time (BST) fMRI analysis resulted in three ROIs that have significant change in BOLD signal (z = 3.25, P <0.05) over the course of bladder runs comparing full versus empty bladder state. Rs-fcMRI fixed effects analysis identified significant changes in connectivity between full and empty bladder states in seven brain regions (z = 4.0) using the three BST ROIs and sixteen brain regions (z = 7) using the twenty MET ROIs. Regions identified include medial frontal gyrus, posterior cingulate (PCC), inferiolateral temporal and post-central gyrus, amygdale, the caudate, inferior parietal lobe as well as anterior and middle cingulate gyrus.
There is significant and vast changes in the brain's functional connectivity when bladder is filled suggesting that the central process responsible for the increased control during the full bladder state appears to largely rely on the how distributed brain systems are functionally integrated.
本研究旨在确定参与膀胱控制的脑机制。
我们使用功能磁共振成像（fMRI）来识别膀胱充盈时被激活的脑区。然后，我们使用静息态功能连接磁共振成像（rs-fcMRI）来评估fMRI识别出的脑区在膀胱充盈至容量时与大脑其他部分的功能连接。
20名女性参与者年龄在40至64岁之间，无明显症状性尿失禁病史。时间主效应（MET）fMRI分析显示，在膀胱细微充盈和排空过程中，无论膀胱处于充盈还是排空状态，有20个感兴趣区域（ROI）的血氧水平依赖（BOLD）信号有显著变化（z = 3.25，P < 0.05）。膀胱状态×时间（BST）fMRI分析显示，在比较膀胱充盈与排空状态的过程中，有3个ROI的BOLD信号有显著变化（z = 3.25，P < 0.05）。rs-fcMRI固定效应分析显示，使用3个BST ROI时，7个脑区（z = 4.0）在膀胱充盈和排空状态之间的连接有显著变化；使用20个MET ROI时，16个脑区（z = 7）有显著变化。识别出的脑区包括内侧额回、后扣带回（PCC）、颞下外侧和中央后回、杏仁核、尾状核、顶下叶以及前扣带回和中扣带回。
膀胱充盈时大脑的功能连接存在显著且广泛的变化，这表明在膀胱充盈状态下负责增强控制的中枢过程似乎很大程度上依赖于分布式脑系统的功能整合方式。
