The effect of stroke on micturition associated brain activity: A pilot fMRI study. Issue 8 (6th August 2020)

• Record Type: Journal Article
• Authors: Kreydin, Evgeniy I.; Gad, Parag; Gao, Bingchen; Liu, Charles Y.; Ginsberg, David A.; Jann, Kay
• Is Part Of: Neurourology and urodynamics. Volume 39:Issue 8(2020:Nov.)
• Page Start: 2198
• Page End: 2205
• Publication Date: 2020-08-06
• Subjects: brain activity -- functional -- lower urinary tract symptoms -- magnetic resonance imaging -- stroke; Urinary organs -- Periodicals; Urodynamics -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1002/nau.24473
• Languages: English
• ISSNs: 0733-2467

Abstract

Abstract: Objective: Cerebral stroke is a unique model for studying the role of the brain in lower urinary tract (LUT) control. By its nature, stroke must change the activity of the brain to cause LUT dysfunction. The objective of this study was to describe changes in micturition‐related brain activity in patients who develop LUT symptoms (LUTS) after a cerebral stroke. Materials and Methods: Healthy controls (HC, n = 10) and patients who developed storage LUTS after a cerebral stroke (n = 7) were recruited. Functional magnetic resonance imaging was used to assess brain activity in each subject. In the task‐based block design, blood‐oxygen‐level‐dependent (BOLD) signal was detected during rest, active bladder filling, and bladder voiding. BOLD signal intensity was compared between HCs and stroke subjects during bladder filling, voiding, and voiding initiation. Results: Stroke subjects exhibited higher activity in the periaqueductal gray and cerebellum during bladder filling and bladder voiding. HCs exhibited more intense activity in higher centers, such as the cingulate cortex, motor cortex, and the dorsolateral prefrontal cortex in each of the phases examined. Conclusions: Subjects with stroke‐related LUTS exhibit a specific pattern of brain activity during bladder filling and voiding. There appears to be a greater reliance on primitive centers (cerebellum, midbrain) than in healthy controls during both phases of the micturition cycle. We hypothesize that these findings may reflect loss of connectivity with higher brain centers after a stroke.