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Related Concept Videos

The Micturition Reflex01:26

The Micturition Reflex

Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
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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
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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.

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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.