7T MRI to study functional urological disorders

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Case in Clinical science

Dennis Frings studies pathology in afferent sensory information during bladder filling

As researchers at the urology department of the Erasmus MC, Dennis Frings and Professor Bertil Blok are interested in the reason why in some functional urological disorders, for instance in overactive bladder (OAB), patients experience a desire to void that does not correlate with their degree of bladder filling. Therefore, their work at the Spinoza Centre focuses on pathology in afferent sensory information during bladder filling.

This group of patients often qualifies for treatment with sacral neuromodulation (SNM), in which an electrical lead is surgically inserted along the sacral nerves to then modulate their activity using low frequency electrical stimulation. This therapy often normalizes bladder sensations in these patients. However, the mechanism by which SNM does this is not fully understood.

In this collaborative project together with the Maastricht UMC and Scannexus, both OAB patients and healthy volunteers will undergo 7T fMRI scanning sessions during bladder filling while the sensory input is gradually increased during the resting state scan. This will make it possible to see activation patterns in empty bladder and full bladder states and to compare them between healthy volunteers and OAB patients. Additionally, OAB patients will all receive SNM therapy and return for a second scanning session afterwards, during which the SNM device will provide active electrical stimulation, which has not been done before.

The increased SNR of 7T fMRI provides useful information in individual subjects. This might make the activation patterns useful for diagnostics in a clinical setting, which is not feasible with functional imaging at lower field strengths. This could make a difference for patients in the near future.