Cerebellar functional connectivity relates to lower urinary tract function: A 7 Tesla study

• Published in: Neurourology and urodynamics Vol. 43; no. 8; pp. 2147 - 2156
• Main Authors: Mazeaud, Charles, Bernard, Jessica A., Salazar, Betsy H., Su, Johnny, Karmonik, Christof, Khavari, Rose
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.11.2024
• Subjects: Adult; Bladder; brain; Brain Mapping; Cerebellum; Cerebellum - diagnostic imaging; Cerebellum - physiology; Female; Functional magnetic resonance imaging; functional MRI; Humans; Lower Urinary Tract Symptoms - diagnostic imaging; Lower Urinary Tract Symptoms - physiopathology; Magnetic Resonance Imaging; Male; Neural networks; Neural Pathways - diagnostic imaging; Neural Pathways - physiology; Neuroimaging; Neurological diseases; resting state; Sex differences; Statistical analysis; Urinary Bladder - diagnostic imaging; Urinary Bladder - physiology; Urinary tract; Urination; Urination - physiology; Urogenital system; Young Adult; functional MRI; resting state; brain; cerebellum; bladder
• ISSN: 0733-2467; 1520-6777; 1520-6777
• DOI: 10.1002/nau.25535

Objectives The objective of this study is to explore the functional connectivity (FC) of the cerebellum during the storage phase of micturition, through detecting spontaneous blood‐oxygen‐level dependent signal between the cerebellum and different brain regions using a high‐resolution 7 Tesla magnetic resonance imaging (MRI) scanner. Materials and Methods We recruited healthy individuals with no reported history of neurological disease or lower urinary tract (LUT) symptoms. Participants were asked to drink 500 mL of water and then empty their bladders before entering the MRI scanner. They underwent a T1‐weighted anatomical scan, followed by an initial (8 min) empty bladder resting state functional MRI (rs‐fMRI) acquisition. Once subjects felt the desire to void, a second rs‐fMRI scan was obtained, this time with a full bladder state. We established a priori cerebellar regions of interest from the literature to perform seed‐to‐voxel analysis using nonparametric statistics based on the Threshold Free Cluster Enhancement method and utilized a voxel threshold of p < 0.05. Results Twenty individuals (10 male and 10 female) with a median age of 25 years (IQR [3.5]) participated in the study. We placed 31 different 4‐mm spherical seeds throughout the cerebellum and assessed their FC with the remainder of the brain. Three of these (left cerebellar tonsil, right posterolateral lobe, right posterior lobe) showed significant differences in connectivity when comparing scans conducted with a full bladder to those with an empty bladder. Additionally, we observed sex differences in FC, with connectivity being higher in women during the empty bladder condition. Conclusion Our initial findings reveal, for the first time, that the connectivity of the cerebellar network is modulated by bladder filling and is associated with LUT function. Unraveling the cerebellum's role in bladder function lays the foundation for a more comprehensive understanding of urinary pathologies affecting this area.