Neuroimaging of situational urgency and incontinence provoked by personal urgency cues

Introduction Situational triggers for urinary urgency and incontinence (UUI) such as “latchkey incontinence” and running water are often reported clinically, but no current clinical tools exist to directly address symptoms of UUI provoked by environmental stimuli. Previously we have shown that urgen...

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Bibliographic Details
Published in:Neurourology and urodynamics 2022-01, Vol.41 (1), p.166-173
Main Authors: Clarkson, Becky D., Wei, Zhiyang, Karim, Helmet T., Tyagi, Shachi, Resnick, Neil M., Salkeld, Ronald P., Conklin, Cynthia A.
Format: Article
Language:English
Subjects:
bladder control
brain
Cues
Environmental effects
Female
Humans
LUTS
Magnetic Resonance Imaging
MRI
Neuroimaging
Parahippocampal gyrus
situational incontinence
Urinary Incontinence - diagnostic imaging
Urinary Incontinence, Urge - therapy
UUI
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Summary:Introduction Situational triggers for urinary urgency and incontinence (UUI) such as “latchkey incontinence” and running water are often reported clinically, but no current clinical tools exist to directly address symptoms of UUI provoked by environmental stimuli. Previously we have shown that urgency and leakage can be reproduced during urodynamic studies with exposure to personal urgency‐related images. Here we investigate the neural signatures associated with such situational triggers to inform potential therapies for reducing reactivity to these personal urgency‐related cues among women with situational UUI. Method We recruited 23 women with situational UUI who took photographs of their personal “urgency trigger” and “safe” situations and were exposed to them in a magnetic resonance imaging (MRI) scanner. We identified brain areas that were more active during urgency versus safe image exposure. Results We found that, during urgency image exposure, main components of the attention network and decision‐related processes, the middle and medial frontal gyri, were more active (p 
ISSN:0733-2467
1520-6777
DOI:10.1002/nau.24800