title: Effect of high level of bladder filling on spinal nociception and motoneuronal excitability.
abstract: To verify whether high level of bladder distension may counteract the inhibitory effect of descending pathways on sacral spinal cord neurons and to investigate which spinal circuitries are possibly involved in such a viscero-somatic interaction. Nociceptive withdrawal reflex (NWR), cutaneous silent period (CSP), and H-reflex were recorded in both lower and upper limbs of twenty-eight healthy subjects. Subjects were examined during baseline (empty bladder, no voiding desire), high level of bladder filling (urgency desire), and control (empty bladder, no voiding desire) sessions. Results showed that the NWR and its related pain perception were reduced in the upper limbs, while only a pain perception reduction in males was observed in the lower limbs. The H-reflex was inhibited in both limbs. No effects were found on the CSP duration. The decrease in both the NWR and its related pain perception in the upper limbs confirms the presence of a bladder distension-induced descending inhibitory modulation on nociception at spinal level. The lack of a similar inhibitory effect in the lower limbs suggests that excitatory nociceptive inputs from bladder afferents counterbalance the inhibitory effect on sacral spinal cord. The lack of the descending inhibitory effect may be a mechanism aimed at forcing the micturition phase to avoid bladder damage caused by bladder sovradistension.
authors: Unit of Neurorehabilitation, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, ICOT, Corso della Repubblica 79, 40100, Latina, Italy.
authors: Gaia
authors: G
authors: Fragiotta
authors: Unit of Neurorehabilitation, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, ICOT, Corso della Repubblica 79, 40100, Latina, Italy.
authors: Francesca
authors: F
authors: Cortese
authors: Unit of Neurorehabilitation, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, ICOT, Corso della Repubblica 79, 40100, Latina, Italy.|Department of Neurophysiology of Vision and Neurophtalmology, G.B. Bietti Eye Foundation-IRCCS, Rome, Italy.
authors: Gianluca
authors: G
authors: Coppola
authors: Unit of Urology, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, ICOT, Latina, Italy.
authors: Antonio
authors: A
authors: Carbone
authors: Unit of Urology, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, ICOT, Latina, Italy.
authors: Antonio Luigi
authors: AL
authors: Pastore
authors: Unit of Urology, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, ICOT, Latina, Italy.
authors: Giovanni
authors: G
authors: Palleschi
authors: Unit of Neurorehabilitation, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, ICOT, Corso della Repubblica 79, 40100, Latina, Italy.
authors: Santo
authors: S
authors: Mastroianni
authors: Fondazione Don Gnocchi, Milan, Italy.
authors: Carmela
authors: C
authors: Conte
authors: IRCCS Mediterranean Neurological Institute NEUROMED, Pozzilli (Isernia), Italy.
authors: Armando
authors: A
authors: Perrotta
authors: Unit of Neurorehabilitation, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, ICOT, Corso della Repubblica 79, 40100, Latina, Italy.|IRCCS Mediterranean Neurological Institute NEUROMED, Pozzilli (Isernia), Italy.
authors: Francesco
authors: F
authors: Pierelli
authors: Unit of Neurorehabilitation, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, ICOT, Corso della Repubblica 79, 40100, Latina, Italy. mariano.serrao@uniroma1.it.
authors: Mariano
authors: M
authors: Serrao
mesh_terms: D000328:Adult; D005121:Extremities / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D009046:Motor Neurons / Q000502:physiology*; D059225:Nociception / Q000502:physiology*; D058748:Pain Perception / Q000502:physiology*; D012018:Reflex / Q000502:physiology*; D012447:Sacrum; D012737:Sex Factors; D013116:Spinal Cord / Q000502:physiology*; D001743:Urinary Bladder / Q000502:physiology*
keywords: Bladder distension; Nociceptive reflexes; Pain modulation; Viscero-somatic interaction