基于fNIRS对女性不同膀胱状态下盆底肌收缩任务的前额叶激活情况

fNIRS-based study of prefrontal cortex activation during pelvic floor muscle contraction in women under different bladder states

目的为探讨前额叶在人体控尿功能中发挥的作用提供神经影像学依据。方法利用近红外脑功能成像技术(fNIRS)收集20名健康成年女性志愿者膀胱充盈和空虚状态下盆底肌收缩时大脑前额皮层的血流动力学数据,并对数据进行相应的处理,通过分析各个通道所提取的氧合血红蛋白浓度的相对变化量所对应的Beta值,对比前额叶不同脑区间激活情况差异。结果膀胱充盈状态下前额皮层共有30个通道激活,膀胱空虚状态下前额皮层共有8个通道激活(P均<0.05),其中共同激活通道有7个;相较于空虚状态,膀胱充盈时的前额叶激活更明显,且以右侧脑区激活为主,差异主要体现在右侧背外侧前额叶和额极(P均<0.05)。结论盆底肌收缩运动可以使大脑前额皮层被激活。当膀胱处于充盈状态时大脑前额皮层可能会通过神经反射活动感知膀胱的压力变化,从而参与调控盆底肌的自主舒缩运动,实现其在人体控尿功能中的作用,其中右侧背外侧前额叶脑区在此过程中发挥的作用可能更为明显。

Objective To provide a neuroimaging basis for exploring the role of the prefrontal cortex in human urinary control function.Methods Hemodynamic data from the prefrontal cortex of the brain during the task of pelvic floor muscle contraction from 20 healthy female volunteers were collected using functional near-infrared spectroscopy(fNIRS)under two different states of bladder filling and emptying,and these data were processed accordingly to compare the differences in the activation state among different brain compartments of the prefrontal cortex by analyzing the Beta values corresponding to the relative amount of changes in the concentration of oxyhemoglobin extracted from each individual channel.Results A total of 30 channels were activated during bladder filling,whereas 8 channels were activated during bladder emptying(all P<0.05),including 7 co-activated channels.The prefrontal cortex activation was more significant during bladder filling than bladder emptying,and the activation was predominantly in the right prefrontal cortex,with the differences mainly in the right dorsolateral prefrontal cortex and frontopolar cortex(all P<0.05).Conclusions The prefrontal cortex can be activated by pelvic floor muscle contraction.Under the state of bladder filling,the prefrontal cortex may perceive the pressure change of the bladder through neural reflex activity and thus participate in the regulation of the voluntary pelvic floor muscle contraction,plays a role in human urinary control function.The right dorsolateral prefrontal cortex region possibly plays a more significant role in this process.