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Related Experiment Videos

Imaging bladder sensations.

Derek Griffiths1

  • 1Division of Geriatric Medicine and Institute on Aging, University of Pittsburgh, Pennsylvania 15213, USA. griffithsdj@dom.pitt.edu

Neurourology and Urodynamics
|July 27, 2007
PubMed
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Brain imaging reveals that overactive bladder (OAB) urgency differs from normal bladder filling sensations. OAB responses are exaggerated at specific volumes, suggesting abnormal brain signal processing, not just bladder hypersensitivity.

Area of Science:

  • Neuroscience
  • Urology

Background:

  • Normal bladder filling sensations follow a continuum of increasing intensity.
  • Urgency, a key symptom of overactive bladder (OAB), is distinct from this normal continuum.
  • Functional magnetic resonance imaging (fMRI) can map brain responses to bladder filling.

Purpose of the Study:

  • To compare brain responses to bladder filling in women with normal bladder control versus those with urge incontinence.
  • To investigate the neural basis of abnormal urgency sensations in OAB.

Main Methods:

  • fMRI was used to image cerebral responses during bladder filling in female volunteers.
  • Participants included women with normal bladder control and women with urge incontinence.

Main Results:

Related Experiment Videos

  • Normal bladder filling sensations activate the insula, with anterior shifts as sensation intensifies.
  • In women with urge incontinence, brain responses were small at low volumes but exaggerated above a threshold, even without detrusor overactivity.
  • This threshold for exaggerated brain response correlated with patient-reported urgency volume thresholds.

Conclusions:

  • Abnormal urgency in OAB is unlikely due to simple bladder hypersensitivity.
  • The findings suggest an abnormality in the nature or brain processing of afferent bladder signals in OAB.