Pd07-04 Functional Neuroimaging of Spinal Cord Regions Involved in Lower Urinary Tract Control in Men and Women

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction (PD07)1 May 2024PD07-04 FUNCTIONAL NEUROIMAGING OF SPINAL CORD REGIONS INVOLVED IN LOWER URINARY TRACT CONTROL IN MEN AND WOMEN Betsy H. Salazar, Charles Mazeaud, Kristopher A. Hoffman, Christof Karmonik, and Rose Khavari Betsy H. SalazarBetsy H. Salazar , Charles MazeaudCharles Mazeaud , Kristopher A. HoffmanKristopher A. Hoffman , Christof KarmonikChristof Karmonik , and Rose KhavariRose Khavari View All Author Informationhttps://doi.org/10.1097/01.JU.0001008552.16893.70.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Despite advances in functional neuroimaging (fMRI) of brain control over the bladder during the past three decades, there have been no attempts to investigate the neuroimaging activity of the spinal cord in real-time in humans. The aim of this study was to develop a fMRI protocol capable of detecting and characterizing lumbosacral spinal cord (SC) activity in healthy men and women. This was accomplished utilizing task fMRI during empty and full bladder states by eliciting the simulated bulbocavernosus reflex (sBCR) via suprapubic tapping. METHODS: Healthy adults (≥18 years) with no history of urinary symptoms nor neurological diseases participated in the study. In neuroimaging sessions, subjects drank 250-500mL of water, immediately followed by voiding prior to entering the MRI scanner. We then conducted anatomical scans, followed by task-based full and empty bladder fMRI sBCR scans. Data were analyzed using a custom pipeline (Spinal Cord Toolbox, FSL, and MATLAB scripts). RESULTS: Twenty individuals (9 men, 11 women), with an average age of 31.3 years participated in the study. Data for 3 of the participants was excluded due to issues during data acquisition. First level analysis yielded activation in 15 (7 men, 8 women) participants with varying patterns of activity between T10-L1 vertebral level during sBCR elicitation in both empty and full bladder states (Figure 1); 2 women showed no activity. Overall, 71% of men displayed more concentrated regions of activation during both sBCR task fMRI (Figure 1A), while 63% of women displayed sparce regions of activation during sBCR (Figure 1B). Activated regions observed include sympathetic (T10-L2), parasympathetic (S2-S4), and somatic nuclei (S2-S4) that are known to coordinate LUT function. Further, results showed activation around S2-S4 spinal levels during both bladder states (empty and full) as expected during sBCR. Activation seen between T10-L2 can be explained by the presence of sympathetic innervation involved during the storage phase of the micturition reflex. CONCLUSIONS: Our preliminary results show for the first time that this functional imaging protocol is able to detect task induced sBCR activity in the SC and underscores our ability to target specific regions responsible for control of LUT function utilizing fMRI. Download PPT Source of Funding: This work was funded by a CAIRIBU Collaboration Award under U24-DK-127726 and in part by 1R01DK134340 © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e168 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Betsy H. Salazar More articles by this author Charles Mazeaud More articles by this author Kristopher A. Hoffman More articles by this author Christof Karmonik More articles by this author Rose Khavari More articles by this author Expand All Advertisement PDF downloadLoading ...