Department of Urology, Houston Methodist Hospital, Houston, Texas, USA.
Department of Urology, Nancy University Hospital, IADI-UL-INSERM (U1254), Nancy, France.
Neurourol Urodyn. 2024 Nov;43(8):2147-2156. doi: 10.1002/nau.25535. Epub 2024 Jul 4.
OBJECTIVES: The objective of this study is to explore the functional connectivity (FC) of the cerebellum during the storage phase of micturition, through detecting spontaneous blood-oxygen-level dependent signal between the cerebellum and different brain regions using a high-resolution 7 Tesla magnetic resonance imaging (MRI) scanner. MATERIALS AND METHODS: We recruited healthy individuals with no reported history of neurological disease or lower urinary tract (LUT) symptoms. Participants were asked to drink 500 mL of water and then empty their bladders before entering the MRI scanner. They underwent a T1-weighted anatomical scan, followed by an initial (8 min) empty bladder resting state functional MRI (rs-fMRI) acquisition. Once subjects felt the desire to void, a second rs-fMRI scan was obtained, this time with a full bladder state. We established a priori cerebellar regions of interest from the literature to perform seed-to-voxel analysis using nonparametric statistics based on the Threshold Free Cluster Enhancement method and utilized a voxel threshold of p < 0.05. RESULTS: Twenty individuals (10 male and 10 female) with a median age of 25 years (IQR [3.5]) participated in the study. We placed 31 different 4-mm spherical seeds throughout the cerebellum and assessed their FC with the remainder of the brain. Three of these (left cerebellar tonsil, right posterolateral lobe, right posterior lobe) showed significant differences in connectivity when comparing scans conducted with a full bladder to those with an empty bladder. Additionally, we observed sex differences in FC, with connectivity being higher in women during the empty bladder condition. CONCLUSION: Our initial findings reveal, for the first time, that the connectivity of the cerebellar network is modulated by bladder filling and is associated with LUT function. Unraveling the cerebellum's role in bladder function lays the foundation for a more comprehensive understanding of urinary pathologies affecting this area.
目的:本研究旨在通过使用高分辨率 7 特斯拉磁共振成像(MRI)扫描仪,检测小脑与不同脑区之间自发血氧水平依赖信号,探索储尿期小脑的功能连接。
材料和方法:我们招募了无神经系统疾病或下尿路(LUT)症状报告史的健康个体。参与者被要求先饮用 500 毫升水,然后在进入 MRI 扫描仪前排空膀胱。他们接受了 T1 加权解剖扫描,然后进行初始(8 分钟)空膀胱静息状态功能 MRI(rs-fMRI)采集。一旦受试者感到有排尿的欲望,就会进行第二次 rs-fMRI 扫描,此时膀胱充盈。我们根据无阈值聚类增强方法,从文献中确定了小脑的先验感兴趣区,并利用体素阈值 p < 0.05 进行了种子到体素分析。
结果:20 名个体(10 名男性和 10 名女性)参与了研究,中位年龄为 25 岁(IQR [3.5])。我们在小脑内放置了 31 个不同的 4 毫米球形种子,并评估了它们与大脑其余部分的连接。在比较充盈膀胱和排空膀胱的扫描时,其中三个(左侧小脑扁桃体、右侧后外侧叶、右侧后叶)的连接存在显著差异。此外,我们观察到连接在女性空膀胱状态下更高,存在性别差异。
结论:我们的初步发现首次表明,小脑网络的连接受膀胱充盈调节,并与 LUT 功能相关。揭示小脑在膀胱功能中的作用为更全面地理解影响该区域的泌尿病理奠定了基础。
Neurourol Urodyn. 2024-11