Brain-bladder control network: the unsolved 21st century urological mystery

Area of Science:

• Neuroscience
• Urology

Background:

• Bladder control involves complex neural pathways.
• Understanding these pathways is crucial for treating bladder dysfunction.

Purpose of the Study:

• To review functional brain imaging studies on bladder control.
• To compare neural responses in normal and overactive bladder conditions.

Main Methods:

• Review of functional brain imaging studies.
• Analysis of neural activity during bladder storage and voiding phases.

Main Results:

• Normal bladder control involves the periaqueductal gray, insula, anterior cingulate cortex, and prefrontal cortex.
• Overactive bladder patients show exaggerated cortical responses, especially in the anterior cingulate cortex and supplementary motor area, linked to urgency.
• The supplementary motor area is activated during pelvic floor muscle contraction, aiding continence.

Conclusions:

• Functional brain imaging offers insights into bladder dysfunction.
• These studies may aid in developing therapeutic options for chronic bladder disorders.