Thubert T, Jousse M, Deffieux X, Amarenco G
Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, AP-HP, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France; GREEN, groupe de recherche clinique en neuro-urologie, GRCUPMC01, 75020 Paris, France; Service de neuro-urologie et explorations périnéales, hôpital Tenon, groupe hospitalier EST, AP-HP, 75020 Paris, France.
Prog Urol. 2013 Dec;23(17):1511-21. doi: 10.1016/j.purol.2013.07.010. Epub 2013 Sep 9.
The physiopathology of the voiding and urinary continence was one of the hot topic of research these last few years. Unfortunately, anyone have already found a unique cause which could explain urinary incontinence (urge or stress). The concept of cognitive function highlights new ways of research to show the fundamental role of the cortex and the sub-cortex in these diseases.
A comprehensive literature review using Pubmed, Medline, Embase and Cochrane: "cognition, urinary tract, urinary continence, neuroimaging, IRMf, micturition, urge, brain factor and cognitive therapy". In all the articles, 72 really dealt with micturition and cognition.
New imaging techniques allowed to show the relationship between the different brain area involved in the bladder control such as the periaqueductal gray, the hypothalamus, the insula, the anterior cingulated cortex and the prefrontal cortex. These cortical area are equally involved in cognition. An alteration of urinary continence implies a modification of activation of these cortical areas.
A better knowledge of the cognitive side of micturition and urinary continence will allow to improve the treatment of their associated diseases.
排尿及尿失禁的生理病理学是过去几年研究的热点之一。遗憾的是，尚未有人找到能解释尿失禁（急迫性或压力性）的唯一病因。认知功能的概念为研究展示大脑皮质和皮质下结构在这些疾病中的重要作用开辟了新途径。
通过PubMed、Medline、Embase和Cochrane进行全面的文献综述：“认知、尿路、尿失禁、神经影像学、功能磁共振成像、排尿、急迫性、脑因素及认知疗法”。在所有文章中，72篇真正涉及排尿与认知。
新的成像技术能够显示参与膀胱控制的不同脑区之间的关系，如导水管周围灰质、下丘脑、脑岛、前扣带回皮质和前额叶皮质。这些皮质区域同样参与认知过程。尿失禁意味着这些皮质区域激活模式的改变。
深入了解排尿和尿失禁的认知方面将有助于改善相关疾病的治疗。
