Testing a new, intensified infusion-withdrawal protocol for urinary urgency provocation in brain-bladder studies.

Area of Science:

• Neuroscience
• Urology
• Medical Imaging

Background:

• Brain activity during urinary urgency is crucial for understanding bladder control.
• Current functional brain MRI (fMRI) protocols for studying urgency often require large participant groups.
• Investigating brain regions like the insula, medial pre-frontal cortex, and dACC/SMA is key to understanding urgency.

Purpose of the Study:

• To test an intensified infusion-withdrawal protocol for provoking bladder urgency during fMRI.
• To improve signal-to-noise ratio and repeatability for studying urgency urinary incontinence.
• To assess the feasibility and tolerability of the new intense protocol.

Main Methods:

• 12 women over 60 underwent an intense bladder infusion-withdrawal protocol during fMRI.
• Primary analysis focused on brain activity in the insula, medial pre-frontal cortex, and dACC/SMA.
• Test-retest repeatability was assessed using intraclass correlation.

Main Results:

• No significant difference in signal was found in targeted brain regions between protocols.
• The new intense protocol demonstrated poor test-retest repeatability and increased variability.
• Three participants could not tolerate the intense protocol.

Conclusions:

• The tested intense bladder imaging protocol did not offer sufficient signal improvement to justify its poor tolerability and repeatability.
• The findings suggest the original, less intense protocol may be more suitable for studying urgency urinary incontinence with fMRI.
• Further research is needed to develop more effective and tolerable methods for brain imaging in urgency studies.