MP03-15 THE INFLUENCE OF STROKE LATERALITY ON FUNCTIONAL BRAIN ACTIVITY DURING MICTURITION: A URODYNAMIC-FUNCTIONAL MAGNETIC RESONANCE IMAGING STUDY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP03-15 THE INFLUENCE OF STROKE LATERALITY ON FUNCTIONAL BRAIN ACTIVITY DURING MICTURITION: A URODYNAMIC-FUNCTIONAL MAGNETIC RESONANCE IMAGING STUDY Aidin Abedi, Veronica Stefania Montero Arcila, Luis Alejandro Morales Ojeda, Rita Jen, Priya Kohli, Nhi Ha, Sarah Ponce, David Chapman, David Ginsberg, Kay Jann, and Evgeniy Kreydin Aidin AbediAidin Abedi More articles by this author , Veronica Stefania Montero ArcilaVeronica Stefania Montero Arcila More articles by this author , Luis Alejandro Morales OjedaLuis Alejandro Morales Ojeda More articles by this author , Rita JenRita Jen More articles by this author , Priya KohliPriya Kohli More articles by this author , Nhi HaNhi Ha More articles by this author , Sarah PonceSarah Ponce More articles by this author , David ChapmanDavid Chapman More articles by this author , David GinsbergDavid Ginsberg More articles by this author , Kay JannKay Jann More articles by this author , and Evgeniy KreydinEvgeniy Kreydin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003214.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Hemispheric differences in brain function account for the differential effects of stroke laterality on various domains of cognition, sensory-motor function, and decision making. Similarly, the size and location of stroke determine the type and severity of bladder dysfunction in patients with neurogenic lower urinary tract dysfunction (NLUTD). However, the changes in functional brain activity in relation to the side of stroke are yet to be understood. This study aimed to determine the differential patterns of micturition-related neural activity in right- vs. left-sided strokes. METHODS: Patients with a history of chronic (>1yr) ischemic or hemorrhagic strokes and NLUTD were enrolled. Patients underwent urodynamic assessment while micturition-related brain activity was simultaneously assessed using functional magnetic resonance imaging with the blood-oxygen-level-dependent (BOLD) technique. Statistical parametric mapping (SPM) was used to assess the changes in BOLD signal during a 10-second period of maximum urgency. The signal intensity was compared between left- versus right-sided strokes, with age, gender, and time since stroke as covariates. Statistically significant clusters were identified using a p value of <0.001 and cluster size of >25 voxels. RESULTS: A total of 23 patients (16 men, 69.57%; mean age 53.61±9.82) were enrolled, of whom 16 (69.57%) suffered from right-sided strokes. Analysis of the BOLD signal changes during the period of maximum urgency yielded increased intensity in patients with left-sided strokes in eight areas spanning the anterior cingulate (Brodmann area 32), inferior frontal gyrus, middle frontal gyrus, and limbic area (cingulate gyrus) on the left hemisphere; frontal sub-gyral area on the right; and superior frontal gyrus (Brodmann area 8) bilaterally. Two clusters located in the left cerebellar anterior lobe and right limbic lobe (posterior cingulate) showed decreased BOLD signal in left-sided strokes compared to right-sided counterparts. CONCLUSIONS: This study demonstrated the differences in micturition-related brain activity between left- and right-sided strokes and identified ten areas of differential activity. Patients with right-sided strokes demonstrated markedly diminished brain activity in several brain regions that are known to play a role in LUT control. Consistent with the inherent functional differences across the brain hemispheres, stroke laterality is correlated with the changes in brain activation during micturition. Source of Funding: Urology Care Foundation © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e29 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aidin Abedi More articles by this author Veronica Stefania Montero Arcila More articles by this author Luis Alejandro Morales Ojeda More articles by this author Rita Jen More articles by this author Priya Kohli More articles by this author Nhi Ha More articles by this author Sarah Ponce More articles by this author David Chapman More articles by this author David Ginsberg More articles by this author Kay Jann More articles by this author Evgeniy Kreydin More articles by this author Expand All Advertisement PDF downloadLoading ...