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. 2024 Jul 23;13(15):4284.
doi: 10.3390/jcm13154284.

Brain Responses Difference between Sexes for Strong Desire to Void: A Functional Magnetic Resonance Imaging Study in Adults Based on Graph Theory

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Brain Responses Difference between Sexes for Strong Desire to Void: A Functional Magnetic Resonance Imaging Study in Adults Based on Graph Theory

Xiaoqian Ying et al. J Clin Med. .

Abstract

Background: The alternations of brain responses to a strong desire to void were unclear, and the gender differences under the strong desire to void remain controversial. The present study aims to identify the functional brain network's topologic property changes evoked by a strong desire to void in healthy male and female adults with synchronous urodynamics using a graph theory analysis. Methods: The bladders of eleven healthy males and eleven females were filled via a catheter using a specific infusion and withdrawal pattern. A resting-state functional magnetic resonance imaging (fMRI) was performed on the enrolled subjects, scanning under both the empty bladder and strong desire to void states. An automated anatomical labeling (AAL) atlas was used to identify the ninety cortical and subcortical regions. Pearson's correlation calculations were performed to establish a brain connection matrix. A paired t-test (p < 0.05) and Bonferroni correction were applied to identify the significant statistical differences in topological properties between the two states, including small-world network property parameters [gamma (γ) and lambda (λ)], characteristic path length (Lp), clustering coefficient (Cp), global efficiency (Eglob), local efficiency (Eloc), and regional nodal efficiency (Enodal). Results: The final data suggested that females and males had different brain response patterns to a strong desire to void, compared with an empty bladder state. Conclusions: More brain regions involving emotion, cognition, and social work were active in females, and males might obtain a better urinary continence via a compensatory mechanism.

Keywords: brain–bladder control; desire to void; graph theory; resting-state functional magnetic resonance imaging; small-world network; topologic properties.

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Conflict of interest statement

The authors declare that the research was conducted without any potential conflict of interest.

Figures

Figure 1
Figure 1
Bladder filling and fMRI protocol.
Figure 2
Figure 2
Brain functional connection matrix of healthy female and male subjects under both of the states.
Figure 3
Figure 3
The Cp, Lp, Eg, and Eloc in healthy female subjects between both of the states. Legend: It showed that the significantly increased Cp, Lp, Eglob and decreased Eloc in these females. Cp, clustering coefficient; Lp, characteristic path length; Eglob, global efficiency; Eloc, local efficiency (p < 0.05) (y axis label is the σ value; * represents statistically significant data).
Figure 4
Figure 4
The Cp, Lp, Eg and Eloc in healthy male subjects between both of the states. Legend: It showed that the significantly decreased Cp in the female subjects, without significant changes in Cp Lp, Eglob. Cp, clustering coefficient; Lp, characteristic path length; Eg, global efficiency; Eloc, local efficiency (p < 0.05) (y axis label is the σ value; * represents statistically significant data).
Figure 5
Figure 5
The brain regions with an alternated Enodal in the healthy male subjects between both of the states. Legend: (a) For female subjects, a larger Enodal in bilateral calcarine fissure and surrounding cortex, lingual gyrus, and fusiform gyrus were detected under the empty bladder state. (b) Under the strong desire to void state, a larger Enodal in the left inferior frontal gyrus and the orbital part of middle frontal gyrus, right median cingulate, middle occipital gyrus and middle temporal gyrus, and bilateral gyrus rectus, inferior parietal gyrus and supramarginal gyrus was detected in healthy females. (c) The larger Enodal in the right inferior occipital gyrus and thalamus of male subjects under the empty bladder state. (d) The significantly increased Enodal of healthy male subjects presented in right frontal operculum and medial superior frontal gyrus, left supplementary motor area and the bilateral supramarginal gyrus (p < 0.05).

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