You have accessJournal of UrologyImaging/Radiology: Uroradiology II1 Apr 20122198 BRAIN ACTIVITY DURING MICTURITION MEASURED BY FUNCTIONAL MAGNETIC RESONANCE IMAGING Jan Krhút, Jaroslav Tintera, Petr Holý, Roman Zachoval, and Peter Zvara Jan KrhútJan Krhút Ostrava, Czech Republic More articles by this author , Jaroslav TinteraJaroslav Tintera Prague, Czech Republic More articles by this author , Petr HolýPetr Holý Prague, Czech Republic More articles by this author , Roman ZachovalRoman Zachoval Prague, Czech Republic More articles by this author , and Peter ZvaraPeter Zvara Burlington, VT More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2372AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The use of functional magnetic resonance imaging (fMRI) in elucidation of central neuroregulation of various organs and systems grew explosively during the last decade, but only a small number of original research papers focused on brain control of lower urinary tract. Functional MRI studies performed to date focused on brain activity during the storage phase. The goal of this study was to to map brain activity during micturition using fMRI performed simultaneously with urodynamics and slow bladder filling. METHODS We evaluated 12 healthy female volunteers aged 20 – 68 years. The measurements consisted of 210 dynamics, each scanning the brain in 35 slices. The urinary bladder was filled at a rate of 50 mL/min until a strong desire to void was reported at which point the patient was instructed to void. Brain activity was recorded continuously during bladder filling and micturition (Figure). Functional MRI measurements during the micturition phase and during the adjacent portions of the filling phase were used in the final analysis. RESULTS Clusters of brain activity during micturition were identified in the pons, thalamus, cingulate gyrus and the medial prefrontal gyrus. In patients who were unable to void, brain activation was documented in the frontal lobe and posterior cingulate gyrus but not in the pons, thalamus or anterior cingulate gyrus. In 5 patients we identified a reproducible pattern of brain activity during the terminal portion of the filling phase when the patient reported a strong desire to urinate. Due to the anatomical proximity of the brain regions activated during period when a strong desire to urinate was reported and during micturition, it proved impossible to separate them functionally. CONCLUSIONS This new protocol allows for localization of brain structures regulating micturition. Our data suggest that by increasing the number of recordings and monitoring bladder sensation in a more detailed manner will allow precise identification of the brain structures involved in neuroregulation of the lower urinary tract during bladder filling and micturition. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e886 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jan Krhút Ostrava, Czech Republic More articles by this author Jaroslav Tintera Prague, Czech Republic More articles by this author Petr Holý Prague, Czech Republic More articles by this author Roman Zachoval Prague, Czech Republic More articles by this author Peter Zvara Burlington, VT More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...