Supraspinal Control of Urine Storage and Micturition in Men--An fMRI Study.

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Bibliographic Details
Title: Supraspinal Control of Urine Storage and Micturition in Men--An fMRI Study.
Authors: Michels, L., Blok, B.F., Gregorini, F., Kurz, M., Schurch, B., Kessler, T.M., Kollias, S., Mehnert, U.
Publication Year: 2025
Collection: Université de Lausanne (UNIL): Serval - Serveur académique lausannois
Subject Terms: Adolescent, Adult, Brain/physiology, Brain Mapping, Humans, Imagination/physiology, Magnetic Resonance Imaging, Male, Middle Aged, Neural Pathways/physiology, Psychomotor Performance/physiology, Urination/physiology, Urine/physiology, Young Adult
Description: Despite the crucial role of the brain in the control of the human lower urinary tract, little is known about the supraspinal mechanisms regulating micturition. To investigate the central regulatory mechanisms activated during micturition initiation and actual micturition, we used an alternating sequence of micturition imitation/imagination, micturition initiation, and actual micturition in 22 healthy males undergoing functional magnetic resonance imaging. Subjects able to micturate (voiders) showed the most prominent supraspinal activity during the final phase of micturition initiation whereas actual micturition was associated with significantly less such activity. Initiation of micturition in voiders induced significant activity in the brainstem (periaqueductal gray, pons), insula, thalamus, prefrontal cortex, parietal operculum and cingulate cortex with significant functional connectivity between the forebrain and parietal operculum. Subjects unable to micturate (nonvoiders) showed less robust activation during initiation of micturition, with activity in the forebrain and brainstem particularly lacking. Our findings suggest that micturition is controlled by a specific supraspinal network which is essential for the voluntary initiation of micturition. Once this network triggers the bulbospinal micturition reflex via brainstem centers, micturition continues automatically without further supraspinal input. Unsuccessful micturition is characterized by a failure to activate the periaqueductal gray and pons during initiation.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 1460-2199
Relation: Cerebral Cortex; https://iris.unil.ch/handle/iris/196493; serval:BIB_A79350D778DA; 000366454000009
DOI: 10.1093/cercor/bhu140
Availability: https://iris.unil.ch/handle/iris/196493
https://doi.org/10.1093/cercor/bhu140
Accession Number: edsbas.649F99D2
Database: BASE
Description
Abstract:Despite the crucial role of the brain in the control of the human lower urinary tract, little is known about the supraspinal mechanisms regulating micturition. To investigate the central regulatory mechanisms activated during micturition initiation and actual micturition, we used an alternating sequence of micturition imitation/imagination, micturition initiation, and actual micturition in 22 healthy males undergoing functional magnetic resonance imaging. Subjects able to micturate (voiders) showed the most prominent supraspinal activity during the final phase of micturition initiation whereas actual micturition was associated with significantly less such activity. Initiation of micturition in voiders induced significant activity in the brainstem (periaqueductal gray, pons), insula, thalamus, prefrontal cortex, parietal operculum and cingulate cortex with significant functional connectivity between the forebrain and parietal operculum. Subjects unable to micturate (nonvoiders) showed less robust activation during initiation of micturition, with activity in the forebrain and brainstem particularly lacking. Our findings suggest that micturition is controlled by a specific supraspinal network which is essential for the voluntary initiation of micturition. Once this network triggers the bulbospinal micturition reflex via brainstem centers, micturition continues automatically without further supraspinal input. Unsuccessful micturition is characterized by a failure to activate the periaqueductal gray and pons during initiation.
ISSN:14602199
DOI:10.1093/cercor/bhu140