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Assessment of brain activity during voluntary anal sphincter contraction: Comparative study in women with and without fecal incontinence
Author(s) -
Parés D.,
MartínezVilalta M.,
Ortiz H.,
SorianoMas C.,
MaestreGonzalez Y.,
Pujol J.,
Grande L.
Publication year - 2018
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.13347
Subject(s) - fecal incontinence , medicine , sphincter , external anal sphincter , defecation , functional magnetic resonance imaging , anal sphincter , magnetic resonance imaging , supplementary motor area , physical medicine and rehabilitation , anal canal , urology , psychology , rectum , surgery , radiology
Background Voluntary anal sphincter function is driven by an extended network of brain structures, most of which are still unknown. Disturbances in this function may cause fecal incontinence. The aim of this study was to characterize the cerebral areas involved in voluntary contraction of the anorectal sphincter in healthy women and in a group of patients with fecal incontinence by using a standardized functional magnetic resonance imaging ( fMRI ) protocol. Methods This comparative study included 12 healthy women (mean age 53.17 ± 4.93 years) and 12 women with fecal incontinence (56.25 ± 6.94 years). An MRI ‐compatible anal manometer was used to register voluntary external anal sphincter contraction. During brain fMRI imaging, participants were cued to perform 10‐s series of self‐paced anal sphincter contractions at an approximate rate of 1 Hz. Brain structures linked to anal sphincter contractions were mapped and the findings were compared between the 2 study groups. Key Results There were no differences in the evoked brain activity between the 2 groups. In healthy women, group fMRI analysis revealed significant activations in medial primary motor cortices, supplementary motor area, bilateral putamen, and cerebellum, as well as in the supramarginal gyrus and visual areas. In patients with fecal incontinence, the activation pattern involved similar regions without significant differences with healthy women. Conclusions & Inferences This brain fMRI ‐anorectal protocol was able to map the brain regions linked to voluntary anal sphincter function in healthy and women with fecal incontinence.