Page 62 - Bladder Dysfunction in the Context of the Bladder-Brain Connection - Ilse Groenendijk.pdf

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Chapter 3
ABSTRACT
Aims: The primary aim of this study is to demonstrate that 7T-fMRI can visualize the
neural representations of the male pelvic floor in the whole brain of a single subject.
Methods: 17 healthy male volunteers (age 20-47) were scanned in a 7T-MRI scanner (Phil- ips Achieva). The scanning protocol consisted of 2 functional runs using a multiband echo planar imaging sequence and a T1-weighted scan. The subjects executed 2 motor tasks, one involving consecutive pelvic floor muscle contractions (PFMC) and a control task with tongue movements.
Results: In single subjects, results of both tasks were visualized in the cortex, putamen, thalamus and the cerebellum. Activation was seen during PFMC in the superomedial and inferolateral primary motor cortex (M1), supplementary motor area (SMA), insula, mid cingulate gyrus (MCG), putamen, thalamus and in the anterior and posterior lobes of the cerebellum. During tongue movement, activation was seen in the inferolateral M1, SMA, MCG, putamen, thalamus and anterior and posterior lobes of the cerebellum. Tongue activation was found in the proximity of, but not overlapping with, the PFMC activation. Connectivity analysis demonstrated differences in neural networks involved in PFMC and tongue movement.
Conclusions: This study demonstrated that 7T-fMRI can be used to visualize brain areas involved in pelvic floor control in the whole brain of single subjects and defined the specific brain areas involved in PFMC. Distinct differences between brain mechanisms controlling the pelvic floor and tongue movements were demonstrated using connec- tivity analysis.
Keywords: Brain mapping, fMRI, 7 tesla, high-field imaging, single subject, primary mo- tor cortex, pelvic floor.