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Characterizing the cortical pathways underlying visual trigger induced urinary urgency incontinence by functional

Jennifer A Locke1, Andrew Macnab1, Saurabh Garg2

  • 1Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

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Researchers developed a new brain imaging method to study how visual triggers cause urgency urinary incontinence (UUI). Functional MRI (fMRI) identified specific brain regions, like the prefrontal cortex, that activate in response to personalized visual stimuli in UUI patients.

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Area of Science:

  • Neuroscience
  • Urology

Background:

  • Visual triggers are clinically recognized to provoke urgency urinary incontinence (UUI).
  • Current understanding acknowledges cortical control over micturition, but lacks standardized methods to assess visual trigger impacts.

Purpose of the Study:

  • To develop an imaging protocol for characterizing brain responses to personalized visual triggers.
  • To establish a methodology for evaluating brain connectivity in patients with visually triggered urinary urgency.

Main Methods:

  • Developed a specialized MRI protocol for urologic applications.
  • Utilized 3T-Elition Scanner for structural and real-time functional MRI (fMRI).
  • Defined brain regions of interest (ROI) using a validated atlas and analyzed fMRI data during natural bladder filling with personalized visual stimuli.

Main Results:

  • fMRI scans were performed on 10 subjects (4 with UUI, 2 with urgency, 4 controls).
  • All subjects with UUI reported urgency in response to their specific visual triggers.
  • Identified key ROI including periaqueductal gray, anterior cingulate gyrus, pons, and prefrontal cortex, with increased activity in the prefrontal cortex and limbic system.

Conclusions:

  • This study provides proof of principle for using fMRI to evaluate subject-specific visual triggers in UUI.
  • The developed methodology can further explore the causation of visually triggered urinary urgency.