Pd07-05 Volitional and Involuntary Detrusor Contractions in Stroke Patients Compared to Volitional Contractions in Healthy Subjects: An Fmri Study

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction (PD07)1 May 2024PD07-05 VOLITIONAL AND INVOLUNTARY DETRUSOR CONTRACTIONS IN STROKE PATIENTS COMPARED TO VOLITIONAL CONTRACTIONS IN HEALTHY SUBJECTS: AN FMRI STUDY Luis A Morales Ojeda, Stefania Montero Arcila, Aidin Abedi, Priya Kohli, Nhi Ha, Petr Gaburak, David Chapman, David Ginsberg, Kay Jann, and Evgeniy Kreydin Luis A Morales OjedaLuis A Morales Ojeda , Stefania Montero ArcilaStefania Montero Arcila , Aidin AbediAidin Abedi , Priya KohliPriya Kohli , Nhi HaNhi Ha , Petr GaburakPetr Gaburak , David ChapmanDavid Chapman , David GinsbergDavid Ginsberg , Kay JannKay Jann , and Evgeniy KreydinEvgeniy Kreydin View All Author Informationhttps://doi.org/10.1097/01.JU.0001008552.16893.70.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Individuals who have suffered a stroke often encounter detrusor overactivity and urge incontinence. Nevertheless, the specific distinctions in brain activity associated with detrusor overactivity, especially when compared to individuals with healthy bladder functions, remains unexplored. Our study is designed to investigate and compare the neural activity patterns during voluntary and involuntary bladder contractions in stroke patients with the voluntary bladder contractions observed in healthy individuals. METHODS: 16 stroke patients and 16 healthy patients underwent simultaneous BOLD-fMRI of the brain and urodynamics, consisting of four filling cycles. Participants were given the command to void after each filling cycle. Voids within 10 seconds of the void command were considered volitional, while voids outside of this period were considered involuntary. Generalized linear models were constructed for each condition. Second level analysis was performed to compare BOLD effect between detrusor contractions in healthy patients and involuntary (Comparison 1), and voluntary (Comparison 2) contractions in stroke patients. Statistical significance was set at p<0.01 with minimum cluster size of 25 voxels. RESULTS: 8 volitional and 23 involuntary detrusor contractions were identified in stroke survivors; 28 volitional and no involuntary contractions were identified in healthy subjects. No significant differences were found in brain activity between voluntary contractions in stroke and healthy patients. In contrast, increased activity was identified in 15 clusters during volitional contractions in healthy subjects (compared to involuntary contractions in stroke subjects), including the bilateral dorsal anterior cingulate cortex (ACC), basal ganglia, bilateral supplementary motor area, and postcentral (primary somatosensory) and precentral (primary motor) gyri. Involuntary contractions in stroke subjects (compared to volitional contractions in healthy subjects) were linked to higher activity in 20 clusters, including the cerebellum, bilateral temporal lobes, hippocampus, brainstem, basal ganglia, with some activity in the frontal lobes, precentral gyri, and the ACC. CONCLUSIONS: Volitional contractions appear to elicit a consistent cortical activation pattern, irrespective of the patient's underlying phenotype. On the other hand, detrusor overactivity contractions reveal a unique cortical activation pattern. Source of Funding: Urology Care Foundation © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e169 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Luis A Morales Ojeda More articles by this author Stefania Montero Arcila More articles by this author Aidin Abedi More articles by this author Priya Kohli More articles by this author Nhi Ha More articles by this author Petr Gaburak More articles by this author David Chapman More articles by this author David Ginsberg More articles by this author Kay Jann More articles by this author Evgeniy Kreydin More articles by this author Expand All Advertisement PDF downloadLoading ...