Effect of high level of bladder filling on spinal nociception and motoneuronal excitability

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• 作者：Gaia Fragiotta ; Francesca Cortese ; Gianluca Coppola…
• 关键词：Pain modulation ; Viscero ; somatic interaction ; Nociceptive reflexes ; Bladder distension
• 刊名：Experimental Brain Research
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：233
• 期：12
• 页码：3459-3466
• 全文大小：1,127 KB
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• 作者单位：Gaia Fragiotta (1)
  Francesca Cortese (1)
  Gianluca Coppola (1) (2)
  Antonio Carbone (3)
  Antonio Luigi Pastore (3)
  Giovanni Palleschi (3)
  Santo Mastroianni (1)
  Carmela Conte (4)
  Armando Perrotta (5)
  Francesco Pierelli (1) (5)
  Mariano Serrao (1)
  
  1. Unit of Neurorehabilitation, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, ICOT, Corso della Repubblica 79, 40100, Latina, Italy
  2. Department of Neurophysiology of Vision and Neurophtalmology, G.B. Bietti Eye Foundation-IRCCS, Rome, Italy
  3. Unit of Urology, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, ICOT, Latina, Italy
  4. Fondazione Don Gnocchi, Milan, Italy
  5. IRCCS Mediterranean Neurological Institute NEUROMED, Pozzilli (Isernia), Italy
  
• 刊物类别：Biomedical and Life Sciences
• 刊物主题：Biomedicine
  Neurosciences
  Neurology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-1106

文摘

To verify whether high level of bladder distension may counteract the inhibitory effect of descending pathways on sacral spinal cord neurons and to investigate which spinal circuitries are possibly involved in such a viscero-somatic interaction. Nociceptive withdrawal reflex (NWR), cutaneous silent period (CSP), and H-reflex were recorded in both lower and upper limbs of twenty-eight healthy subjects. Subjects were examined during baseline (empty bladder, no voiding desire), high level of bladder filling (urgency desire), and control (empty bladder, no voiding desire) sessions. Results showed that the NWR and its related pain perception were reduced in the upper limbs, while only a pain perception reduction in males was observed in the lower limbs. The H-reflex was inhibited in both limbs. No effects were found on the CSP duration. The decrease in both the NWR and its related pain perception in the upper limbs confirms the presence of a bladder distension-induced descending inhibitory modulation on nociception at spinal level. The lack of a similar inhibitory effect in the lower limbs suggests that excitatory nociceptive inputs from bladder afferents counterbalance the inhibitory effect on sacral spinal cord. The lack of the descending inhibitory effect may be a mechanism aimed at forcing the micturition phase to avoid bladder damage caused by bladder sovradistension. Keywords Pain modulation Viscero-somatic interaction Nociceptive reflexes Bladder distension