Page 31 - Bladder Dysfunction in the Context of the Bladder-Brain Connection - Ilse Groenendijk.pdf

A systematic review and meta-analysis of the central innervation of the lower urinary tract 29
formation of the studies, sample sizes, study population, characteristics describing the scanning protocol, applied analysis and the reported coordinates of supraspinal activity (raw data).
Raw data
The extracted raw data were the coordinates of the activated clusters described by the included studies. The coordinates are shown in the orientation in which they were origi- nally described, i.e. MNI or TAL. Most included studies focusing on micturition, separately reported the coordinates of the patients with successful micturition and unsuccessful micturition. The current study only extracted the coordinates of the subjects with suc- cessful micturition if the data was reported separately. In two studies the distinction between successful and unsuccessful micturition was not made.
Primary outcome: Activation Likelihood Estimation (ALE)
Coordinate-based meta-analyses of neuroimaging results were performed using Gin- gerALE software (version 2.3.6) available on the BrainMap website (http://brainmap.org/ software.html). ALE analysis uses all the reported foci from the included studies as a spatial probability distribution centered at the given coordinates. The analysis accom- modates the spatial uncertainty of neuroimaging findings and uses a spatial variance model. Finally, the convergence of foci is tested against the null-hypothesis of random distribution of foci. The TAL coordinates were converted to MNI space using the icb- m2tal transform within the GingerALE software.12 A lenient threshold was used, taking the amount of data into account (uncorrected p <0.001, minimal volume of 100 mm3). Results were presented on an MNI template using Mango, multi-image viewing software (http://ric.uthscsa.edu/mango/).
Risk of bias assessment
The Cochrane Risk of Bias Assessment tool together with an assessment of the main confounders following recommendations of the Cochrane handbook for nonrandom- ized comparative studies13,14 were used to perform a risk of bias analysis for included nonrandomized comparative studies. Firstly, a manual was developed for scoring the added confounders. Secondly, the main and added confounders were independently scored by two authors (J.G. and I.G.) and discrepancies were discussed. Table 1 shows the used confounders and how they were scored.
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