Rehabilitation School of Capital Medical University, Department of Urology of Capital Medical University, Beijing, China.
Department of Urology, China Rehabilitation Research Centre, Beijing, China.
Neurourol Urodyn. 2020 Sep;39(7):1966-1976. doi: 10.1002/nau.24445.
This resting-state functional magnetic resonance imaging (fMRI) study determined the functional connectivity (FC) changes and topologic property alterations of the brain functional network provoked by a strong desire to void in healthy adults using a graph theory analysis (GTA).
Thirty-four healthy, right-handed subjects filled their bladders by drinking water. The subjects were scanned under an empty bladder and a strong desire to void states. The Pearson's correlation coefficients were calculated among 90 brain regions in the automated anatomical labeling (AAL) atlas to construct the brain functional network. A paired t test (P < .05, after false discovery rate [FDR] correction) was used to detect significant differences in the FC, topologic properties (small-world parameters [gamma, sigma], C, L, E, E, and E) between the two states in all subjects.
Both the two states showed small-world network properties. The clustering coefficient (C) and local efficiency (E) in the whole brain network decreased, while the FC within the default mode network (DMN) increased during the strong desire to void compared with the empty bladder state. Moreover, an increased nodal efficiency (E) was detected in the basal ganglia (BG), DMN, sensorimotor-related network (SMN), and visual network (VN).
We detected FC changes and topologic property alterations in brain functional networks caused by a strong desire to void in healthy and suggest that the micturition control may be a process dominated by DMN and coordinated by multiple sub-networks (such as, BG, SMN, and VN), which could serve as a baseline for understanding the pathologic process underlying bladder dysfunction and be useful to improve targeted therapy in the future.
本静息态功能磁共振成像(fMRI)研究采用图论分析(GTA),确定了健康成年人强烈排尿欲望时大脑功能网络的功能连接(FC)变化和拓扑性质改变。
34 名健康、右利手的受试者通过饮水使膀胱充盈。在膀胱空虚和强烈排尿欲望两种状态下对受试者进行扫描。采用 Pearson 相关系数计算自动解剖标记(AAL)图谱中 90 个脑区之间的脑功能网络。对所有受试者的两种状态下的 FC 和拓扑性质(小世界参数[γ、σ]、C、L、E、E 和 E)进行配对 t 检验(P <.05,经 False Discovery Rate [FDR]校正),以检测差异的显著性。
两种状态均表现出小世界网络特性。与膀胱空虚状态相比,强烈排尿欲望状态时全脑网络的聚类系数(C)和局部效率(E)降低,而默认模式网络(DMN)内的 FC 增加。此外,基底节(BG)、DMN、感觉运动相关网络(SMN)和视觉网络(VN)的节点效率(E)增加。
我们检测到健康成年人强烈排尿欲望时大脑功能网络的 FC 变化和拓扑性质改变,提示排尿控制可能是一个以 DMN 为主导、由多个子网络(如 BG、SMN 和 VN)协调的过程,这可为理解膀胱功能障碍的病理过程提供基线,并有助于未来的靶向治疗。