1610 FUNCTIONAL BRAIN IMAGING (FMRI) AND NATURAL BLADDER FILLING IN HEALTHY VOLUNTEERS

Field: Neuroscience (Life Sciences)

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Urodynamic Testing1 Apr 20101610 FUNCTIONAL BRAIN IMAGING (FMRI) AND NATURAL BLADDER FILLING IN HEALTHY VOLUNTEERS Woon Tsang, Joe Kong, Anupam Yadav, John O'Donaghue, Brian Andrews, Jeremy Noble, Irene Tracey, and John Reynard Woon TsangWoon Tsang More articles by this author , Joe KongJoe Kong More articles by this author , Anupam YadavAnupam Yadav More articles by this author , John O'DonaghueJohn O'Donaghue More articles by this author , Brian AndrewsBrian Andrews More articles by this author , Jeremy NobleJeremy Noble More articles by this author , Irene TraceyIrene Tracey More articles by this author , and John ReynardJohn Reynard More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1390AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The sensation from the presence of a urethral catheter during conventional urodynamics makes it difficult to distinguish bladder sensation from that arising as a consequence of the presence of a catheter within the urethra. In the fMRI investigation of brain centres involved in sensing bladder fullness, a urethral catheter may therefore act as a source of artefact. Using natural bladder filling after oral fluid loading we determined which areas of the brain are associated with sensations of bladder filling. METHODS 11 healthy male volunteers drank a minimal of 1L of fluid 30 minutes before entering the fMRI scanner. After emptying their bladder, they underwent continuous fMRI scanning and rated their bladder sensation every minute (0=No sensation, 1=FSF, 2=FDV, 3=NDV, 4=SDV & 5=Maximum sensation) until maximum sensation was reached. After image acquisition and pre-processing, MELODIC ICA (a model free analysis) was used to compare differences in bladder sensation at low and high bladder volumes. Natural filling (NF) rate was calculated as the voided urine volume at the conclusion of the study (the post-scan void) divided by the time between the pre-scan void and the post-scan void. RESULTS 11 healthy volunteers (mean age 33 years) completed the study with a mean fluid intake of 1386mls (1000 – 1750mls). Mean scanning time was 36 mins (20 – 40mins). The mean voided urine was 669mls (450 – 1000mls). The mean NF rate was 9.6ml/min (5.9 – 13.3ml/min). 4 of 11 (36%) of the subjects experienced first sensation at the start of scanning and 81% had a strong sensation of filling at the end of scanning. Bilateral insular cortex, bilateral thalamus, ACC, PCC and cerebellum (FDR=0.05) were significantly activated during natural filling (Figure 1). Using paired t-test the insular cortex (local FDR=0.05) was significant when comparing low and high bladder volumes (Figure 2). CONCLUSIONS We have used a novel approach to determine regions of brain activation during bladder filling by combining fMRI and natural bladder filling. This technique is likely to produce a more reliable correlation between subjective sensations of bladder filling and areas of brain activity identified during fMRI scanning since it excludes the possible artefactual effect of sensations arising from the presence of a urethral catheter. Oxford, United Kingdom© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e622 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Woon Tsang More articles by this author Joe Kong More articles by this author Anupam Yadav More articles by this author John O'Donaghue More articles by this author Brian Andrews More articles by this author Jeremy Noble More articles by this author Irene Tracey More articles by this author John Reynard More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...