An fMRI study of the role of suprapontine brain structures in the voluntary voiding control induced by pelvic floor contraction

Zhang, Hao; Reitz, André; Kollias, Spyros; Summers, Paul; Curt, Armin; Schurch, Brigitte

doi:10.1016/j.neuroimage.2004.08.027

Cited by 132 publications

(123 citation statements)

References 50 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…] in the scanner since although they had DO, none leaked. The activation of the cerebellum and supplementary motor area seen was in a similar distribution to that shown by fMRI in control subjects who performed pelvic £oor contraction with full bladders and inhibited voiding [Zhang et al, 2005]. Studies of bladder function following implantation of a deep brain stimulator for treatment of advanced movement disorders have show a reduction in DO and increased capacity [Finazzi-Agro et al, 2003;Seif et al, 2004] although the e¡ect of this intervention on urinary symptoms appears to be more complex.…”

Section: The Onset Of Bladder Symptoms In the Progression Of Pdsupporting

confidence: 55%

Update on the neurology of Parkinson's disease

Fowler

2006

Neurourology and Urodynamics

View full text Add to dashboard Cite

The di¡erential diagnosis of a patient with apparent Parkinson's Disease (PD) and bladder symptoms is considered and the bladder dysfunction of Multiple System Atrophy (MSA) is reviewed. Recent insights into the progression of the neuropathology of PD have enabled thinking about the stage of the disease at which bladder dysfunction is likely to occur and the expected clinical context of the problem. Bladder symptoms of neurological origin are likely in a patient who has had treated motor symptoms for some years and in whom the ongoing neuropathology has progressed beyond involvement of the basal ganglia, so that symptoms due to cortical dysfunction as well as the adverse e¡ects of dopaminergic medication are also confounding factors. Bladder symptoms in a man with lesser neurological disability should be investigated to exclude underlying out£ow obstruction. Possible management options are considered. Neurourol. Urodynam. 26: 103^109, 2007.

show abstract

Section: The Onset Of Bladder Symptoms In the Progression Of Pdsupporting

confidence: 55%

Update on the neurology of Parkinson's disease

Fowler

2006

Neurourology and Urodynamics

View full text Add to dashboard Cite

show abstract

“…This is one of the first mechanisms together with adaptations in motor unit recruitment which is involved in the very early changes after starting muscle training [18]. The supraspinal regions involved in EUS control and coordination of pelvic floor muscles including the EUS have been revealed in several imaging studies using PET and fMRI [19]. As our findings demonstrate, PFMT not only decreases the motor threshold during TCMS but also during CLES, which is in principle nothing else than bulbocavernosus reflex testing.…”

Section: Discussionsupporting

confidence: 55%

The facilitatory effect of duloxetine combined with pelvic floor muscle training on the excitability of urethral sphincter motor neurons

et al. 2009

Self Cite

View full text Add to dashboard Cite

The facilitatory effect of duloxetine combined with pelvic floor muscle training on the excitability of urethral sphincter motor neurons The facilitatory effect of duloxetine combined with pelvic floor muscle training on the excitability of urethral sphincter motor neurons Abstract INTRODUCTION AND HYPOTHESIS: Aim of this study was to investigate the excitability of sphincter motor neurons under the influence of pelvic floor muscle training (PFMT) and duloxetine. Due to their mechanisms of action, there might be a synergistic effect of duloxetine and PFMT in regard to the facilitation of spinal reflexes controlling urethral sphincter contractions and hence continence. METHODS: In ten healthy female subjects, clitoral electric stimulation (CES) and transcranial magnetic stimulation (TMS) were used to determine individual motor thresholds for external urethral sphincter (EUS) contractions before and after PFMT, duloxetine, and PFMT + duloxetine. RESULTS: PFMT and duloxetine alone significantly decreased the motor thresholds for EUS contractions during CES and TMS. However, the combined treatment reduced the motor threshold for EUS contractions significantly stronger compared to PFMT or duloxetine alone. CONCLUSIONS: The results are suggestive for a synergistic facilitatory effect of PFMT and duloxetine on sphincter motor neuron activation.The facilitatory effect of duloxetine combined with pelvic floor muscle training on the excitability of urethral sphincter motor neurons.

show abstract

“…A limitation is the repeated and rapid infusion minus withdrawal used to elicit brain responses which, although unphysiological, mimicked bladder filling more closely than other fMRI paradigms (Kuhtz-Buschbeck et al, 2005;Seseke et al, 2006;Zhang et al, 2005). The imaged field of view was restricted axially to 90 mm; to ensure coverage of the PMC and L-region, the paracentral lobule, important in pelvic floor control (Blok et al, 1997a;Kuhtz-Buschbeck et al, 2005;Zhang et al, 2005), was omitted in some subjects.…”

Section: Limitationsmentioning

confidence: 99%

“…Bladder control is exercised by the brain via a long-loop spinobulbospinal reflex pathway that includes the midbrain periaqueductal gray (PAG) and the pontine micturition center (PMC), which in turn are controlled by a supratentorial network. The main network landmarks are known from animal and clinical observations, and from functional imaging by positron emission tomography (PET) (Athwal et al, 2001;Blok et al, 1997b;Kitta et al, 2006;Matsuura et al, 2002;Nour et al, 2000) or functional magnetic resonance imaging (fMRI) (Di Gangi Herms et al, 2006;Griffiths et al, 2005;KuhtzBuschbeck et al, 2005;Seseke et al, 2006;Zhang et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Cerebral control of the bladder in normal and urge-incontinent women

et al. 2007

View full text Add to dashboard Cite

Aim: To identify age-related changes in the normal brain/bladder control system, and differences between urge incontinence in younger and older women, as shown by brain responses to bladder filling; and to use age, bladder volume, urge incontinence and detrusor overactivity (DO) as probes to reveal control-system function. Functional MRI was used to examine regional brain responses to bladder infusion in 21 females (26 -85 years): 11 "cases" with urge incontinence and DO (proven previously) and 10 normal "controls". Responses and their age dependence were determined at small and large bladder volumes, in whole brain and in regions of interest representing right insula and anterior cingulate (ACG). In "controls", increasing bladder volume/sensation led to increasing insular responses; with increasing age, insular responses became weaker. In younger "cases", ACG responded abnormally strongly at large bladder volumes/strong sensation. Elderly "cases" showed strong ACG responses even at small bladder volume, but more moderate responses at larger volumes; if DO occurred, pontine micturition center (PMC) activation did not increase. Conclusion:Among normal "controls", increasing age leads to decreased responses in brain regions involved in bladder control, including right insula, consistent with its role in mapping normal bladder sensations. Strong ACG activation occurs in urge-incontinent "cases" and may be a sign of urgency, indicating recruitment of alternative pathways when loss of bladder control is feared. Easier ACG provocation in older "cases" reflects lack of physiological reserve or different etiology. ACG responses seem associated with PMC inhibition: reduced ACG activity accompanies failure of inhibition (DO).

show abstract

An fMRI study of the role of suprapontine brain structures in the voluntary voiding control induced by pelvic floor contraction

Cited by 132 publications

References 50 publications

Update on the neurology of Parkinson's disease

Update on the neurology of Parkinson's disease

The facilitatory effect of duloxetine combined with pelvic floor muscle training on the excitability of urethral sphincter motor neurons

Cerebral control of the bladder in normal and urge-incontinent women

Contact Info

Product

Resources

About