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Switching off micturition using deep brain stimulation at midbrain sites
Alexander L Green1, Ella Stone, Holly Sitsapesan
1Nuffield Department of Surgical Science, University of Oxford, UK.
Annals of Neurology
|July 26, 2012
Summary
Deep brain stimulation in the periaqueductal gray matter can control the micturition (urination) circuitry. This technique helps defer urination and maintain urinary continence, even with a full bladder.
Area of Science:
- Neuroscience
- Urology
- Neurobiology
Background:
- The bladder typically operates in a storage mode, switching to voiding only when deemed safe or socially appropriate.
- Urinary continence relies on complex neural control mechanisms.
- Dysfunction in these pathways can lead to urinary incontinence.
Purpose of the Study:
- To investigate the potential of deep brain stimulation to modulate the micturition control circuitry.
- To determine if targeted brain stimulation can influence urinary continence.
- To explore new therapeutic strategies for urinary incontinence.
Main Methods:
- Deep brain stimulation was applied to the periaqueductal gray matter in both human and rodent models.
- The effects of stimulation on bladder switching and continence were assessed.
- Reversibility and rapidity of the stimulation effects were evaluated.
Main Results:
- Deep brain stimulation of the periaqueductal gray matter rapidly and reversibly manipulated the micturition control circuitry.
- This intervention successfully deferred voiding and maintained urinary continence, even when the bladder was full.
- Neural pathways governing continence were effectively modulated.
Conclusions:
- Deep brain stimulation in the periaqueductal gray matter offers a method to control the micturition reflex.
- This approach demonstrates potential for treating urinary incontinence of central origin.
- Targeting neural continence pathways via deep brain stimulation presents novel therapeutic avenues.
Related Concept Videos
01:26The Micturition Reflex
Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...
01:14Brain Imaging
Brain imaging technologies provide critical insights into both the structure and function of the human brain, enabling medical professionals and researchers to diagnose, study, and treat neurological disorders or psychiatric disorders more effectively.
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), and Transcranial Magnetic Stimulation (TMS).
These technologies include computerized axial tomography (CAT or CT scans), positron-emission tomography (PET scans), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), and Transcranial Magnetic Stimulation (TMS).