The document discusses functional brain imaging techniques that have been applied to studying bladder control, such as fMRI, SPECT, and PET scans. It summarizes some of the key findings from this research, including that areas of the brainstem, insula, anterior cingulate cortex, and pre-motor cortex are activated during bladder filling and voiding. The document also provides an overview of the history of neuroanatomy and neurophysiology research related to micturition from the 1920s to the present day when functional brain imaging is now being used to further understand normal and abnormal bladder function.

1. Functional Brain Imaging applied to bladder control

2. The new ( “ brain “ ) urodynamics

5. fMRI BOLD

7. f-MRI (1.5 - 3 Tesla )

8. Esempi di compito

9. 1 - Subject lies in the scanner

10. 2 - Task is performed ( bladder filled manually or through distant urodynamic equipment)

11. 3 - Scanner captures and process brain images

13. How the brain works ?

19. POSITRON EMISSION TOMOGRAPHY (PET) SCANS DURING BLADDER FILLING Pons Peri-aqueductal grey

21. Insula activity during bladder filling

27. MICTURITION Animated Work-up Model

28. Bladder Filling Kavia and Fowler 04 Courtesy CJF

29. Micturition Kavia and Fowler 04 Courtesy CJF

30. PMC S2-4 in cauda equina pelvic & pudendal ns

31. Brain Imaging & Micturition Literature to date

32. Poor Bladder Control ( urgency & DO) Rosenberg LJ , Griffiths DJ, Resnick DM , J.Urol, 2005

33. DO &Urgency as different entities (Tadic ,2009)

34. STRESS INCONTINENCE Neuroplastic Changes after PFM Training Di Gangi H , 2009

37. BRAIN and BLADDER From Barrington cats to human Functional Brain Imaging Giancarlo Vignoli Unità di Urodinamica & Uroginecologia Casa Madre Fortunata Toniolo Bologna

41. The nineties Neuroscience

45. Brain Imaging sections

47. Bladder “ noise “ Structures involved ( Fry C , ICI 2008)

48. Application of Functional Imaging to Pathophysiological Conditions