Modulation of Viscero-Somatic H-reflex during Bladder Filling: A Possible Tool in the Differential Diagnosis of Neurogenic Voiding Dysfunctions

Carbone, Antonio; Palleschi, Giovanni; Parascani, R.; Morello, P; Conte, Antonella; Inghilleri, Maurizio

doi:10.1016/s0302-2838(02)00309-3

Cited by 9 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We, however, confidently exclude this possibility since previous studies have shown that modulation of H-reflex amplitude occurs at the point of medium bladder filling (i.e. 200 ml) (Inghilleri et al, 2001;Carbone et al, 2002), which is in terms of urinary volume comparable to the maximum neobladder filling (200-250 ml) observed in our study. We also consider unlikely that neobladder filling failed to modulate the H reflex size due to a disruption of the abdominal afferents signaling because surgical procedures were specifically performed in order to maintain a normal innervation.…”

Section: Introductionsupporting

confidence: 65%

Does the neobladder filling modulate soleus H reflex?

Palleschi

Conte

Pastore

et al. 2014

Clinical Neurophysiology

View full text Add to dashboard Cite

Section: Introductionsupporting

confidence: 65%

Does the neobladder filling modulate soleus H reflex?

Palleschi

Conte

Pastore

et al. 2014

Clinical Neurophysiology

View full text Add to dashboard Cite

“…This study extends previous investigations on the same topic (Inghilleri et al 2001;Carbone et al 2002;Palleschi et al 2014;Serrao et al 2014). The main results we obtained can be summarized as follows: (i) both NWR and its related pain perception were reduced only in the upper limbs; conversely, the H-reflex was inhibited in both limbs; (ii) NWR pain-related perception (NRS) was decreased in males in both limbs, while in females, no significant changes were observed in lower limbs; and (iii) no effects were found on the CSP duration.…”

Section: Discussionsupporting

confidence: 90%

Effect of high level of bladder filling on spinal nociception and motoneuronal excitability

et al. 2015

View full text Add to dashboard Cite

To verify whether high level of bladder distension may counteract the inhibitory effect of descending pathways on sacral spinal cord neurons and to investigate which spinal circuitries are possibly involved in such a viscero-somatic interaction. Nociceptive withdrawal reflex (NWR), cutaneous silent period (CSP), and H-reflex were recorded in both lower and upper limbs of twenty-eight healthy subjects. Subjects were examined during baseline (empty bladder, no voiding desire), high level of bladder filling (urgency desire), and control (empty bladder, no voiding desire) sessions. Results showed that the NWR and its related pain perception were reduced in the upper limbs, while only a pain perception reduction in males was observed in the lower limbs. The H-reflex was inhibited in both limbs. No effects were found on the CSP duration. The decrease in both the NWR and its related pain perception in the upper limbs confirms the presence of a bladder distension-induced descending inhibitory modulation on nociception at spinal level. The lack of a similar inhibitory effect in the lower limbs suggests that excitatory nociceptive inputs from bladder afferents counterbalance the inhibitory effect on sacral spinal cord. The lack of the descending inhibitory effect may be a mechanism aimed at forcing the micturition phase to avoid bladder damage caused by bladder sovradistension.

show abstract

“…If cross‐organ communication exists between colon and urinary bladder (6), bladder filling will produce similar effects of colorectal distension and inhibit the cutaneous nociceptive reflexes (ie, SNR). Our results confirm that visceral afferents may modulate and suppress spinal excitability in healthy humans (15–17). Inhibition could be one of the mechanisms of continence that holds urine within the bladder.…”

Section: Discussionsupporting

confidence: 82%