title: Functional Brain Imaging and the Neural Basis for Voiding Dysfunction in Older Adults.
abstract: Brain abnormalities may contribute to the increased prevalence of urinary dysfunction such as overactive bladder and urge incontinence in older individuals. Functional brain imaging suggests that 3 independent neural circuits (frontal, midcingulate, and subcortical) control voiding by suppressing the voiding reflex in the brainstem periaqueductal gray. Damage to the connecting pathways subserving these circuits (white matter hyperintensities) increases with age and is associated both with severity of urge incontinence and changes in brain function. Multicomponent therapies targeting structural and functional neural abnormalities may be more effective than any single treatment focused on the bladder.
authors.affiliation: Urology Division, Department of Surgery, UConn Center on Aging, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA. Electronic address: ppsmith@uchc.edu.
authors.forename: Phillip P
authors.initials: PP
authors.lastname: Smith
authors.affiliation: Division of Geriatrics, UConn Center on Aging, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, USA.
authors.forename: George A
authors.initials: GA
authors.lastname: Kuchel
authors.affiliation: Geriatric Medicine, University of Pittsburgh, 3471 Fifth Avenue, Suite 500, Pittsburgh, PA 15213, USA.
authors.forename: Derek
authors.initials: D
authors.lastname: Griffiths
mesh_terms: D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods*; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D008297:Male; D001743:Urinary Bladder / Q000294:innervation* / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000209:etiology* / Q000503:physiopathology; D014549:Urinary Incontinence / Q000503:physiopathology*; D014551:Urinary Tract / Q000294:innervation; D014554:Urination / Q000502:physiology
keywords: Aging; Bladder; Elderly; Frailty; Lower urinary tract; Urinary incontinence