A resting-state functional MRI study on central control of storage: brain response provoked by strong desire to void

In order to observe central responses during naturally occurring urinary bladder storage in healthy subjects, we examined brain areas that control strong bladder sensation by resting-state functional magnetic resonance imaging (rs-fMRI).

All subjects were right-handed and scanned twice under the following two conditions: empty bladder and full bladder ('strong desire to void') without the use of filling with a catheter. Brain imaging software (DPARSF and REST) was adopted to analyze the difference in brain-blood perfusion between the two conditions. Voxel-based analysis of the regional homogeneity (Reho) maps between empty and full bladder was performed with a paired t test. Statistical maps were set at P value <0.05 and were corrected for multiple comparisons.

The rs-fMRI scans of 30 healthy subjects (8 men and 22 women, between 24 and 49 years of age) were analyzed. The responses became stronger in the state of strong desire to void (P < 0.05). Increased activity during strong desire to void was observed in the prefrontal cortex (PFC), anterior cingulate cortex (ACC), hypothalamus, temporal lobes and left caudate nucleus, which are involved in bladder perception related to large volumes in adults.

There are significant changes in the brain's Reho during the strong sensation to void. The results suggest that the PFC, the ACC, hypothalamus, temporal lobes and left caudate nucleus play a role in the cerebral control of bladder storage without artificial bladder filling in healthy people.