Frontal executive function and the bladder: A study of dementia with Lewy bodies

Haruta, Hiroyuki; Sakakibara, Ryuji; Ogata, Tsuyoshi; Tateno, Fuyuki; Kusumoto, Masahiko; Aiba, Yosuke; Uchiyama, Tomoyuki; Yamamoto, Tatsuya

doi:10.1111/ncn3.12237

Cited by 4 publications

(1 citation statement)

References 30 publications

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“…Clinical studies have shown that in elderly subjects with urodynamic detrusor overactivity and OAB symptoms, the OAB was not closely associated with general cognitive task (as measured by the Mini-Mental State Examination [MMSE]) but was closely associated with an inhibitory control task (a category of the Frontal Assessment Battery [FAB], a function of decision-making), indicating that a loss of general inhibition by the PFC lesion may lead to both OAB and disturbed decision-making [77]. Similar findings were observed in another investigation [78].…”

Section: Brain Area Relevant To the Luts: Cortical Structuressupporting

confidence: 69%

How brain diseases affect the lower urinary tract function?

Sakakibara

Yamamoto

Sekido

et al. 2022

Bladder

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This article reviewed brain mechanism of the lower urinary tract (LUT). Among autonomic nervous systems, LUT is unique in terms of afferent pathophysiology; bladder sensation is perceived soon after the storage phase and throughout the voiding phase. Within the brain, this is measured in experimental animals by the firing of single neurons and in humans by evoked potentials/functional neuroimaging. The evidence indicates that sphincter information goes up to the precentral motor cortex and other brain areas, and bladder information goes up to the insular cortex (IC)/anterior cingulate (ACG) and further to the prefrontal cortex (PFC). Another LUT-specific phenomenon is efferent pathophysiology: detrusor overactivity (exaggerated micturition reflex) occurs in brain diseases such as stroke (focal disease) and dementia with Lewy bodies (diffuse diseases, may overlap with each other). With the turning off and on of the brain-switch of micturition (at the periaqueductal gray [PAG]), there is a bladder-inhibitory PFC-IC/ACG-hypothalamus-PAG pathway, with interconnections via the PFC with a PFC-nigrostriatal D1 dopaminergic pathway and a PFC-cerebellar pathway. Brain diseases that affect these areas may cause a loss of the brain's inhibition of the micturition reflex, leading to detrusor overactivity. This has a significant clinical impact on patients and requires appropriate management.

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Section: Brain Area Relevant To the Luts: Cortical Structuressupporting

confidence: 69%