Brain activation during the voiding phase of micturition in healthy adults: A meta‐analysis of neuroimaging studies

Abstract

Several studies have used a variety of neuroimaging techniques to measure brain activity during the voiding phase of micturition. However, there is a lack of consensus on which regions of the brain are activated during voiding. The aim of this meta-analysis is to identify the brain regions that are consistently activated during voiding in healthy adults across different studies. We searched the literature for neuroimaging studies that reported brain co-ordinates that were activated during voiding. We excluded studies that reported co-ordinates only for bladder filling, during pelvic floor contraction only, and studies that focused on abnormal bladder states such as the neurogenic bladder. We used the activation-likelihood estimation (ALE) approach to create a statistical map of the brain and identify the brain co-ordinates that were activated across different studies. We identified nine studies that reported brain activation during the task of voiding in 91 healthy subjects. Together, these studies reported 117 foci for ALE analysis. Our ALE map yielded six clusters of activation in the pons, cerebellum, insula, anterior cingulate cortex (ACC), thalamus, and the inferior frontal gyrus. Regions of the brain involved in executive control (frontal cortex), interoception (ACC, insula), motor control (cerebellum, thalamus), and brainstem (pons) are involved in micturition. This analysis provides insight into the supraspinal control of voiding in healthy adults and provides a framework to understand dysfunctional voiding. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc.

A systematic review and activation likelihood estimation meta-analysis of the central innervation of the lower urinary tract: Pelvic floor motor control and micturition

“…Micturition is a complex process, involving both voluntary and involuntary control regulated by a supraspinal network [ 11 , 12 ]. Until 1996, all available evidence for supraspinal micturition control was obtained from animal studies in cats [ 37 ] or from case reports of humans with lesions in the prefrontal cortex [ 38 ].…”

Abnormal Degree Centrality in the Right Inferior Frontal Gyrus During Urine Holding in Children With Primary Monosymptomatic Nocturnal Enuresis

“…The IFG is associated with micturition control [16,17]. Activation of the PFC has been found both in people who wanted to empty but could not as well as those who could successfully void [18].…”

Anterior cingulate cortex modulates the affective‐motivative dimension of hyperosmolality‐induced thirst

“…A previous study has shown that ACC is activated during the voiding phase of micturition (Harvie et al . ) and during bladder filling (de Groat et al . ).…”