Neuroimaging in Neuro-Urology

Abstract

Neuroimaging allows in vivo visualization of neuronal structures/processes to assess their involvement in bodily functions. This is particularly valuable for the assessment of complex, multilevel neuronal controlled functions, such as urine storage and micturition. Using positron emission tomography or functional magnetic resonance imaging, significant alterations of supraspinal lower urinary tract (LUT) control have been described in patients with neurogenic LUT dysfunction due to spinal cord injury, Parkinson's disease, and multiple sclerosis. Severity of such alterations often correlates with symptom/dysfunction severity, both of which could be partly mitigated by therapeutic interventions. However, the overall evidence and study quality are presently very limited, and a multidisciplinary approach will be required to achieve clinical relevance in the long term. PATIENT SUMMARY: We reviewed the findings of neuroimaging studies in patients with bladder dysfunction due to neurological trauma/disease. Changes in the nervous systems of these patients alter bladder control, and neuroimaging may become a valuable tool for assessing these alterations.

Keywords: Functional magnetic resonance imaging; Lower urinary tract; Micturition; Multiple sclerosis; Neuroimaging; Neuronal pathways; Parkinson’s disease; Positron emission tomography; Spinal cord injury; Supraspinal control; Urine storage.