Is the Brainstem Activation Different Between Healthy Young Male and Female Volunteers at Initiation of Voiding? A High Definition 7-Tesla Magnetic Resonance Imaging Study
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: Assessing brainstem function in humans through typical neuroimaging modalities has been challenging. Our objective was to evaluate brain and brainstem activation patterns during initiation of voiding in healthy males and females utilizing a 7 Tesla magnetic resonance imaging (MRI) scanner and a noninvasive brain-bladder functional MRI (fMRI) protocol. Methods: Twenty healthy adult volunteers (10 males and 10 females) with no history of urinary symptoms were recruited. Each volunteer underwent a clinic uroflow and postvoid residual assessment and was asked to consume water prior to entering the scanner. Anatomical and diffusion tensor images were obtained first, followed by a blood oxygenation level dependent (BOLD) resting-state fMRI (rs-fMRI) during the empty bladder. Subjects indicated when they felt the urge to void, and a full bladder rs-fMRI was obtained. Once completed, the subjects began 5 voiding cycles, where the first 7.5 seconds of each voiding cycle was identified as “initiation of voiding.” BOLD activation maps were generated, and regions of interests with a t-value greater than 2.1 were deemed statistically significant. Results: We present 5 distinct regions within the periaqueductal gray (PAG) and pontine micturition center (PMC) with statistically significant activation associated with an initiation of voiding in both men and women, 3 within the PAG and 2 within the PMC. Several additional areas in the brain also demonstrated activation as well. When comparing males to females, there was an overall lower BOLD activation seen in females throughout all regions, with the exception of the caudate lobe. Conclusions: Our study effectively defines regions within the PAG and PMC involved in initiation of voiding in healthy volunteers. To our knowledge, this is the first study investigating differences between male and female brainstem activation utilizing an ultra-high definition 7T MRI.
Abstract
Purpose: Assessing brainstem function in humans through typical neuroimaging modalities has been challenging. Our objective was to evaluate brain and brainstem activation patterns during initiation of voiding in healthy males and females utilizing a 7 Tesla magnetic resonance imaging (MRI) scanner and a noninvasive brain-bladder functional MRI (fMRI) protocol. Methods: Twenty healthy adult volunteers (10 males and 10 females) with no history of urinary symptoms were recruited. Each volunteer underwent a clinic uroflow and postvoid residual assessment and was asked to consume water prior to entering the scanner. Anatomical and diffusion tensor images were obtained first, followed by a blood oxygenation level dependent (BOLD) resting-state fMRI (rs-fMRI) during the empty bladder. Subjects indicated when they felt the urge to void, and a full bladder rs-fMRI was obtained. Once completed, the subjects began 5 voiding cycles, where the first 7.5 seconds of each voiding cycle was identified as “initiation of voiding.” BOLD activation maps were generated, and regions of interests with a t-value greater than 2.1 were deemed statistically significant. Results: We present 5 distinct regions within the periaqueductal gray (PAG) and pontine micturition center (PMC) with statistically significant activation associated with an initiation of voiding in both men and women, 3 within the PAG and 2 within the PMC. Several additional areas in the brain also demonstrated activation as well. When comparing males to females, there was an overall lower BOLD activation seen in females throughout all regions, with the exception of the caudate lobe. Conclusions: Our study effectively defines regions within the PAG and PMC involved in initiation of voiding in healthy volunteers. To our knowledge, this is the first study investigating differences between male and female brainstem activation utilizing an ultra-high definition 7T MRI.
참고문헌 (24)
- Isaacs BR, "3 versus 7 Tesla magnetic resonance imaging for parcellations of subcortical brain structures in clinical settings", PLoS One, 15, pp.e0236208~ (2020)
- de Rijk MM, "Parcellation of human periaqueductal gray at 7-T fMRI in full and empty bladder state : the foundation to study dynamic connectivity changes related to lower urinary tract functioning", Neurourol Urodyn, 40, pp.616~623 (2021)
- Blok BF, "A PET study on brain control of micturition in humans", Brain, 120(Pt 1), pp.111~121 (1997)
- de Groat WC, "Organization of the neural switching circuitry underlying reflex micturition", Acta Physiol(Oxf), 207, pp.66~84 (2013)
- Blok BF, "Two pontine micturition centers in the cat are not interconnected directly : implications for the central organization of micturition", J Comp Neurol, 403, pp.209~218 (1999)
- Griffiths D, "Neural control of micturition in humans : a working model", Nat Rev Urol, 12, pp.695~705 (2015)
- Blok BF, "Brain activation during micturition in women", Brain, 121(Pt 11), pp.2033~2042 (1998)
- Griffiths DJ, "The micturition switch and its forebrain influences", Acta Physiol(Oxf), 207, pp.93~109 (2013)
- Ogawa S, "Brain magnetic resonance imaging with contrast dependent on blood oxygenation", Proc Natl Acad Sci U S A, 87, pp.9868~9872 (1990)
- Thulborn KR, "Oxygenation dependence of the transverse relaxation time of water protons in whole blood at high field", Biochim Biophys Acta, 714, pp.265~270 (1982)
- Vincent K, "Blood oxygenation level dependent functional magnetic resonance imaging : current and potential uses in obstetrics and gynaecology", BJOG, 116, pp.240~246 (2009)
- Ogawa S, "Functional brain mapping by blood oxygenation level-dependent contrast magnetic resonance imaging. A comparison of signal characteristics with a biophysical model", Biophys J, 64, pp.803~812 (1993)
- Mumford JA, "Power calculation for group fMRI studies accounting for arbitrary design and temporal autocorrelation", Neuroimage, 39, pp.261~268 (2008)
- Desmond JE, "Estimating sample size in functional MRI(fMRI)neuroimaging studies : statistical power analyses", J Neurosci Methods, 118, pp.115~128 (2002)
- Harvie C, "Brain activation during the voiding phase of micturition in healthy adults : a meta-analysis of neuroimaging studies", Clin Anat, 32, pp.13~19 (2019)
- Nitti VW, "The prevalence of urinary incontinence", Rev Urol, 3(Suppl 1), pp.S2~S6 (2001)
- Irwin DE, "Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries:results of the EPIC study", Eur Urol, 50, pp.1306~1314 (2006)
- Coyne KS, "The prevalence of lower urinary tract symptoms (LUTS)in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study", BJU Int, 104, pp.352~360 (2009)
- Seseke S, "Gender differences in voluntary micturition control : an fMRI study", Neuroimage, 43, pp.183~191 (2008)
- van Haarst EP, "The 24-h frequency-volume chart in adults reporting no voiding complaints : defining reference values and analysing variables", BJU Int, 93, pp.1257~1261 (2004)
- Michels L, "Supraspinal control of urine storage and micturition in men--an fMRI study", Cereb Cortex, 25, pp.3369~3380 (2015)
- Shy M, "Functional magnetic resonance imaging during urodynamic testing identifies brain structures initiating micturition", J Urol, 192, pp.1149~1154 (2014)
- Mawla I, "Natural bladder filling alters resting brain function at multiple spatial scales : a proof-of-concept MAPP Network Neuroimaging Study", Sci Rep, 10, pp.19901~ (2020)
- Lai HH, "The LURN Research Network Neuroimaging and Sensory Testing (NIST) study: design, protocols, and operations", Contemp Clin Trials, 74, pp.76~87 (2018)