2168 BLADDER DEFAULT MODE NETWORK (DMN) – A NEW CONCEPT FOR BLADDER CONTROL IN THE ‘RESTING STATE'

Abstract

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Urodynamic Testing1 Apr 20112168 BLADDER DEFAULT MODE NETWORK (DMN) – A NEW CONCEPT FOR BLADDER CONTROL IN THE ‘RESTING STATE' Woon Tsang, Joe Kong, Chris Beckmann, John Reynard, and Irene Tracey Woon TsangWoon Tsang Oxford, United Kingdom More articles by this author , Joe KongJoe Kong Oxford, United Kingdom More articles by this author , Chris BeckmannChris Beckmann Oxford, United Kingdom More articles by this author , John ReynardJohn Reynard Oxford, United Kingdom More articles by this author , and Irene TraceyIrene Tracey Oxford, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.2405AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Functional brain imaging (fMRI) during bladder filling has identified regional brain activation but little is known about bladder sensation networks. A ‘default mode network' (DMN) in the bladder has been postulated as being active when the bladder is at rest (empty)1. Our objectives were to identify a possible DMN in the empty bladder, changes to the DMN in the full bladder and differences in the DMN between healthy volunteers (HV) and overactive bladder (OAB) patients. METHODS 20 subjects (7 good bladder control and 13 OAB) had fMRI with conventional urodynamics using a previously developed block paradigm of an infusion:pause sequence. After image acquisition and pre-processing, MELODIC ICA (a model free analysis) was used to look for a DMN in an empty bladder and changes in a full bladder. RESULTS In the group as a whole, the medial prefrontal cortex (mPFC) and the preconeus (p<0.05) were activate when the bladder was empty (the ‘resting state'). Brain activity with a full bladder shifted to the lateral PFC, insular cortex and anterior cingulate cortex (ACC) (p<0.05) (Figure 1). The mean neural activity in the resting condition decreased when the bladder was full (Figure 2). In the resting state for HV ((mean age 40 years), the mPFC, ACC, preconeus, cerebellum and the brain stem (p<0.05) were activated (Figure 3) and only the preconeus and ACC (p<0.05) were activated in OAB subjects (mean age 54 years) (Figure 4). The differences between the groups (Figure 5) were found in the MPFC and brainstem (p<0.001). CONCLUSIONS This study provides the first evidence for the existence of a bladder DMN. The mPFC has a pivotal role in continence control and activity within this centre is the main difference in the DMN between HV (mPFC active with bladder fullness) and OAB (no mPFC activity with bladder fullness). References 1 : Neuroimage2009; . Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e868 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Woon Tsang Oxford, United Kingdom More articles by this author Joe Kong Oxford, United Kingdom More articles by this author Chris Beckmann Oxford, United Kingdom More articles by this author John Reynard Oxford, United Kingdom More articles by this author Irene Tracey Oxford, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...