Santoso Anugrah D, Sunaert Stefan, De Ridder Dirk
Laboratory of Experimental Urology, Department of Development and Regeneration, KU Leuven, Herestraat 49, Leuven, 3000, Belgium.
Department of Urology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Sci Rep. 2025 Jul 2;15(1):22491. doi: 10.1038/s41598-025-05447-6.
Understanding the central control of bladder perception is important to comprehend the neurophysiological mechanism behind bladder sensation and lower urinary tract dysfunction. Here we design a sensation-driven functional magnetic resonance imaging (fMRI) during repetitive bladder filling and examine brain activation related to the first desire to void (FDV) and strong desire to void (SDV) sensations. These sensations are subjective and can be transient, making their study particularly challenging and insightful. To prevent constant engagement of the viscerosensory cortex and to add a layer of complexity, a diversion continuous performance task (CPT) was randomly presented. We modelled and analysed the data given the recorded responses and assessed the validity and reliability of our paradigm. Brain activation was then compared to the canonical functional networks to understand how the brain responded to the transition between CPT and the desire to void. Our approach improved reliability metrics and revealed that SDV triggered more pronounced brain activation than FDV. This underscores a robust relationship between urinary urge intensity and signal intensity. We also pinpointed several brainstem structures linked to the desire to void. Ultimately, our findings demonstrated dynamic interaction among brain functional networks during the transition between goal-driven tasks and reorienting to salient stimuli.
了解膀胱感觉的中枢控制对于理解膀胱感觉和下尿路功能障碍背后的神经生理机制至关重要。在此,我们设计了一种在膀胱反复充盈过程中基于感觉驱动的功能磁共振成像(fMRI),并检查与首次排尿欲望(FDV)和强烈排尿欲望(SDV)感觉相关的脑激活情况。这些感觉是主观的且可能是短暂的,这使得对它们的研究特别具有挑战性且富有洞察力。为了防止内脏感觉皮层持续参与,并增加一层复杂性,随机呈现一项分心连续执行任务(CPT)。我们根据记录的反应对数据进行建模和分析,并评估我们范式的有效性和可靠性。然后将脑激活与典型功能网络进行比较,以了解大脑对CPT和排尿欲望之间转换的反应方式。我们的方法提高了可靠性指标,并揭示出SDV比FDV引发更明显的脑激活。这强调了排尿冲动强度与信号强度之间的稳健关系。我们还确定了几个与排尿欲望相关的脑干结构。最终,我们的研究结果证明了在目标驱动任务和重新定向到显著刺激之间的转换过程中,脑功能网络之间存在动态相互作用。