Simultaneous EMG-fMRI during startle inhibition in monosymptomatic enuresis--an exploratory study.
Evidence is growing that monosymptomatic enuresis (ME) is a maturational disorder of the central nervous system with a lack of arousal and lacking inhibition of the micturition reflex. Previous studies have shown a significant reduction of prepulse inhibition (PPI) of startle in children with enures...
| Published in: | European Journal of Pediatrics Vol. 172; no. 1; pp. 23 - 31 |
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| Main Authors: | , , , , , , , , , |
| Format: | research Journal Article |
| Published: |
Springer Nature
Jan2013
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104293427&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104293427 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03406199 CR1 jtl: European Journal of Pediatrics issn: 03406199 maglogo: N pubinfo: dt: Jan2013 vid: 172 iid: 1 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104293427 104293427 NLM22986772 2011898023 10.1007/s00431-012-1829-y NLM22986772 104293427 ppf: 23 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Simultaneous EMG-fMRI during startle inhibition in monosymptomatic enuresis--an exploratory study. aug: au: Schulz-Juergensen S Wunberg D Wolff S Eggert P Siniatchkin M Schulz-Juergensen, Sebastian Wunberg, David Wolff, Stephan Eggert, Paul Siniatchkin, Michael affil: Department of General Pediatrics, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3, Haus 9, 24105 Kiel, Germany sug: subj: Brain Stem Physiopathology Electromyography Methods Enuresis Physiopathology Magnetic Resonance Imaging Methods Reflex Physiology Adolescence Child Female Human Male Adolescent: 13-18 years Child: 6-12 years Female Male ab: Evidence is growing that monosymptomatic enuresis (ME) is a maturational disorder of the central nervous system with a lack of arousal and lacking inhibition of the micturition reflex. Previous studies have shown a significant reduction of prepulse inhibition (PPI) of startle in children with enuresis. However, it is still unclear whether the abnormal PPI in enuresis is based on an inhibitory deficit at brainstem or cortical level. Nine children with ME and ten healthy children were investigated using simultaneous recording of EMG from the M. orbicularis oculi and functional MRI. The experimental paradigm consisted of acoustic startle stimulation, with startle-alone stimuli and prepulse-startle combinations. Functional MRI data were processed using multiple regression and parametric modulation with startle amplitudes as a parameter. Neither patients with enuresis nor healthy children revealed measurable PPI in the MRI scanner. Startle stimuli caused equal hemodynamic changes in the acoustic cortex, medial prefrontal and orbitofrontal cortex in both groups. The amplitude of startle correlated with more prominent BOLD signal changes in the anterior cingulate cortex in healthy subjects than in patients with ME. This pronounced frontal activation in healthy controls was related to the PPI condition, indicating that the prefrontal cortex of healthy children was activated more strongly to inhibit startle than in patients with ME. In conclusion, apart from the possibility that recordings of PPI inside the MRI scanner may be compromised by methodological problems, the results of this study suggest that high cortical control mechanisms at the prefrontal level are relevant for the pathogenesis of ME. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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