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Spinal Cord Lower Urinary Tract Control in Humans.
Betsy H Salazar1, Charles M Mazeaud1,2, Kristopher A Hoffman1,3
1Department of Urology, Houston Methodist Hospital, Houston, Texas.
Neurourology and Urodynamics
|April 30, 2025
Summary
This study developed a new functional magnetic resonance imaging (fMRI) method to observe real-time spinal cord activity during bladder control. The technique successfully detected neural signals in key areas, advancing our understanding of lower urinary tract function.
Area of Science:
- Neuroimaging
- Urology
- Spinal Cord Research
Background:
- Limited understanding of real-time spinal cord involvement in human bladder control.
- Advancements in functional magnetic resonance imaging (fMRI) offer new avenues for investigation.
Purpose of the Study:
- To develop and validate an fMRI protocol for assessing spinal cord activity related to bladder function.
- To investigate innate spinal cord activity in humans during bladder filling and simulated reflexes.
Main Methods:
- Twenty healthy adults (9 men, 11 women) underwent spinal cord fMRI.
- Evaluated resting-state and task-based fMRI during natural bladder filling and simulated bulbocavernosus reflex (sBCR).
- Utilized a custom analysis pipeline with Spinal Cord Toolbox, FSL, and MATLAB.
Main Results:
- fMRI detected task-induced spinal cord activity in 15 participants (7 men, 8 women).
- Observed activation patterns across T10-S5 segments during sBCR with empty and full bladders.
- Identified sympathetic, parasympathetic, and somatic nuclei involved in lower urinary tract (LUT) control.
Conclusions:
- Demonstrated the efficacy of a novel fMRI protocol for detecting task-induced activity in the lumbosacral spinal cord.
- Established a method to precisely target spinal regions regulating LUT function.
- Preliminary findings suggest potential sex differences in spinal activation patterns warranting further study.
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