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Related Experiment Videos

Brain control of normal and overactive bladder.

Derek Griffiths1, Stuart Derbyshire, Andy Stenger

  • 1Division of Geriatric Medicine, University of Pittsburgh, and the Magnetic Resonance Research Center, Pittsburgh, Pennsylvania 15213, USA. GriffithsDJ@msx.dept-med.pitt.edu

The Journal of Urology
|October 12, 2005
PubMed
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Poor bladder control is linked to insufficient brain activation in the orbitofrontal cortex. This neuroimaging study reveals key differences in brain responses during bladder filling between individuals with good and poor bladder control.

Area of Science:

  • Neuroscience
  • Urology
  • Medical Imaging

Background:

  • Bladder control issues are prevalent, yet their origins are frequently unknown.
  • Research has primarily focused on the lower urinary tract, overlooking the supraspinal control system's role.
  • Functional magnetic resonance imaging (fMRI) offers a method to investigate brain activity related to bladder function.

Purpose of the Study:

  • To investigate brain responses during bladder filling using fMRI.
  • To compare brain activity in individuals with normal bladder control versus those with poor bladder control (detrusor overactivity).

Main Methods:

  • fMRI scans were conducted on participants (1 male, 11 females, aged 26-83) undergoing bladder infusion and withdrawal.
  • Intravesical pressure was monitored at various bladder volumes (small and large).

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  • Participants were categorized based on prior urodynamic assessments of bladder control (good vs. poor).

    • Main Results:

    • fMRI identified activation in numerous brain regions crucial for bladder control, including the periaqueductal gray, thalamus, insula, dorsal anterior cingulate, and ventromedial cerebellum.
    • Responses intensified with larger bladder volumes, with notable differences between control groups.
    • Individuals with poor bladder control showed exaggerated cortical responses, except in the orbitofrontal cortex, which exhibited weak activation.

    Conclusions:

    • Inadequate activation of the orbitofrontal cortex is specifically associated with poor bladder control.
    • This finding suggests a neurophysiological basis for bladder control problems, mirroring effects seen with frontal cortical lesions.
    • The study highlights the supraspinal control system's importance in maintaining bladder continence.