Kitta Takeya, Mitsui Takahiko, Kanno Yukiko, Chiba Hiroki, Moriya Kimihiko, Shinohara Nobuo
Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.
Int J Urol. 2015 Apr;22(4):342-8. doi: 10.1111/iju.12721. Epub 2015 Feb 17.
A review of functional brain imaging studies of bladder control in participants with normal control and pathological conditions. In the normal condition, bladder and urethral afferents received in the periaqueductal gray relay the information to the insula, the anterior cingulate cortex and the prefrontal cortex. During the storage phase, these superior regions control the pontine micturition center to inhibit voiding. In overactive bladder patients, brain responses are different. Cortical responses become exaggerated, especially in the anterior cingulate cortex and the supplementary motor area. That is what presumably evokes the "urgency". The supplementary motor area is activated during contraction of the pelvic floor muscles, and provides protection against incontinence. We believe that functional brain imaging studies are promising not only for the understanding of bladder dysfunction, but also as an aid to the development of therapeutic options for chronic disorders.
对正常对照和病理状况参与者膀胱控制的功能性脑成像研究的综述。在正常情况下，导水管周围灰质接收的膀胱和尿道传入神经将信息传递至岛叶、前扣带回皮质和前额叶皮质。在储尿期，这些高级区域控制脑桥排尿中枢以抑制排尿。在膀胱过度活动症患者中，脑反应有所不同。皮质反应变得过度，尤其是在前扣带回皮质和辅助运动区。这大概就是引发“急迫感”的原因。辅助运动区在盆底肌肉收缩时被激活，并提供防止尿失禁的保护作用。我们认为功能性脑成像研究不仅对于理解膀胱功能障碍很有前景，而且有助于慢性疾病治疗方案的开发。
