Gender differences in voluntary micturition control — An fMRI study

Seseke, S.; Baudewig, Jürgen; Kallenberg, Kai; Ringert, R.‐H.; Seseke, F.; Dechent, Peter

doi:10.1016/j.neuroimage.2008.07.044

Cited by 37 publications

(49 citation statements)

References 44 publications

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“…None of the subjects was able to initiate the micturition, presumably due to subconscious restraint resulting from the inconvenient situation. The activation sites known from the healthy controls were demonstrated. Again, well‐localized activations in the pontine micturition center (PMC) and the periaqueductal gray (PAG) were identified and activations of the main cortical and subcortical structures could be reproduced in the patients.…”

Section: Resultsmentioning

confidence: 99%

“… Note : All areas known from the healthy volunteers (Seseke et al) are listed. Additional areas specifically activated in our patient group are shown in italics.…”

Section: Resultsmentioning

confidence: 99%

“…After identifying the brain regions which are involved in the normal micturition control by using positron emission tomography (PET) or functional magnetic resonance imaging (fMRI) in the last decades, the next step was to transfer the paradigm to patients with lower urinary tract dysfunction. Several studies identified altered activation levels in those brain structures which are involved in the micturition circuit .…”

Section: Introductionmentioning

confidence: 99%

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Functional MRI in patients with detrusor sphincter dyssynergia: Is the neural circuit affected?

Seseke

Leitsmann

Hijazi³

et al. 2019

Neurourology and Urodynamics

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Aims In recent years, the human brain‐bladder control network has been visualized in different functional magnetic resonance imaging (fMRI) studies. The role of the brainstem and suprapontine regions has been elucidated. Especially the pontine region and the periaqueductal gray, as the central structures of the micturition circuit, were demonstrated. Detrusor sphincter dyssynergia (DSD) is a common problem in patients with neurological diseases. Residual urine and consecutive urinary tract infections with the risk of kidney damage remain a problem. In the present study, we used fMRI of the brain to compare the activation sites of patients with DSD with those of our previously published healthy controls with special emphasis on the brainstem region. Methods fMRI was performed in 11 patients with DSD who had an urge to void due to a filled bladder. In a nonvoiding model, they were instructed to contract or to relax the pelvic floor muscles repetitively. Results In patients with DSD, we could reproduce the activation sites found in healthy subjects, showing the regions in the brainstem as well as the other micturition‐related areas. The activation of the pontine region was more rostral/dorsal compared with the healthy volunteers. Conclusion Interestingly, we detected the well‐known activation in the pontine region in the patients in the dorsal/rostral part compared with the more ventral activation in the healthy volunteers, suggesting that the L‐region of the pontine micturition center is more prominent in cases of DSD.

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Section: Resultsmentioning

confidence: 99%

“… Note : All areas known from the healthy volunteers (Seseke et al) are listed. Additional areas specifically activated in our patient group are shown in italics.…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Functional MRI in patients with detrusor sphincter dyssynergia: Is the neural circuit affected?

Seseke

Leitsmann

Hijazi³

et al. 2019

Neurourology and Urodynamics

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show abstract

“…Similarly, increased PAG rCBF when subjects had a full bladder, but not during intravesical ice water stimulation, suggests that the PAG activation is specific to bladder distention and not other bladder sensation (Matsuura et al, 2002). Voluntary enhancement of the urge to void (Kuhtz-Buschbeck et al, 2005), imitation voiding by releasing — and imitating interruption by contracting — pelvic floor muscles (Seseke et al, 2006, 2008) all lead PAG activation in women (Seseke et al, 2006) and in men (Seseke et al, 2008) with no gender differences in PAG activation magnitude.…”

Section: Resultsmentioning

confidence: 99%

Neuroimaging of the periaqueductal gray: State of the field

et al. 2012

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This review and meta-analysis aims at summarizing and integrating the human neuroimaging studies that report periaqueductal gray (PAG) involvement; 250 original manuscripts on human neuroimaging of the PAG were identified. A narrative review and meta-analysis using activation likelihood estimates is included. Behaviors covered include pain and pain modulation, anxiety, bladder and bowel function and autonomic regulation. Methods include structural and functional magnetic resonance imaging, functional connectivity measures, diffusion weighted imaging and positron emission tomography. Human neuroimaging studies in healthy and clinical populations largely confirm the animal literature indicating that the PAG is involved in homeostatic regulation of salient functions such as pain, anxiety and autonomic function. Methodological concerns in the current literature, including resolution constraints, imaging artifacts and imprecise neuroanatomical labeling are discussed, and future directions are proposed. A general conclusion is that PAG neuroimaging is a field with enormous potential to translate animal data onto human behaviors, but with some growing pains that can and need to be addressed in order to add to our understanding of the neurobiology of this key region.

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“…Reduced MD has been reported in presymptomatic familial Alzheimer's disease, where it was interpreted as reflecting early neuropathological changes such as microglial activation or neuronal and glial swelling, which could hinder diffusion in extracellular spaces . In addition, a rodent study of cerebral infarction directly related decreased MD to markers of acute cell injury …”

Section: Discussionmentioning

confidence: 97%

Investigation of urinary storage symptoms in Parkinson's disease utilizing structural MRI techniques

Roy

Griffiths

Aziz

et al. 2019

Neurourology and Urodynamics

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Background Lower urinary tract symptoms occur in 27% to 86% of patients with Parkinson's disease (PD), however, the mechanisms responsible for bladder dysfunction are not fully understood. This study utilized magnetic resonance imaging (MRI) to test the hypothesis that key brainstem bladder control areas (including the pontine micturition center and the pontine continence center (PCC) and their links with the basal ganglia are important in the development of urinary storage symptoms in PD. Methods Seventeen patients with PD completed a “bladder symptom questionnaire” and underwent diffusion‐weighted MRI (1.5 T). Storage symptom severity and MRI measures of white matter microstructural integrity were correlated using tract‐based spatial statistics. Results Mean diffusivity in the ventral brainstem correlated significantly with the bladder symptom severity in areas close to the predicted anatomical co‐ordinates of the PCC. Tracts seeded from these regions passed via areas involved in pelvic floor musculature control and urinary voiding including the cerebellum, pallidum, and precentral gyrus. Conclusion We used diffusion‐weighted MRI to investigate the role of the brainstem and its structural connections in the development of urinary storage symptoms in PD. Our data suggest that the brainstem degenerative change in the vicinity of the PCC may be implicated in the pathogenesis of storage symptoms in these patients.

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Gender differences in voluntary micturition control — An fMRI study

Cited by 37 publications

References 44 publications

Functional MRI in patients with detrusor sphincter dyssynergia: Is the neural circuit affected?

Functional MRI in patients with detrusor sphincter dyssynergia: Is the neural circuit affected?

Neuroimaging of the periaqueductal gray: State of the field

Investigation of urinary storage symptoms in Parkinson's disease utilizing structural MRI techniques

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