Brain activation patterns of female multiple sclerosis patients with voiding dysfunction.

AIMS: We compared brain activation patterns between female multiple sclerosis (MS) patients with voiding dysfunction (VD) and those without. We aim to expand current knowledge of supraspinal correlates of voiding initiation within a cohort of female MS patients with and without VD. MATERIALS AND METHODS: Twenty-eight ambulatory female MS patients with stable disease and lower urinary tract dysfunction were recruited for this study. Subjects were divided into group 1, without VD (n = 14), and group 2, with VD (n = 14), defined as postvoid residual urine of ≥40% of maximum cystometric capacity or need for self-catheterization. We recorded brain activity via functional magnetic resonance imaging (fMRI) with simultaneous urodynamic testing. Average fMRI activation maps (the Student t test) were created for both groups, and areas of significant activation were identified (P < .05). A priori regions of interest (ROIs), identified by prior meta-analysis to be involved in voiding, were selected. RESULTS: Group-averaged blood-oxygen level-dependent (BOLD) activation maps demonstrated significant differences between groups 1 and 2 during initiation of voiding with group 2 showing significantly lower levels of activation in all ROIs except for the left cerebellum and right cingulate gyrus. Interestingly, group 2 displayed negative BOLD signals, while group 1 displayed positive signals in the right and left pontine micturition center, right periaqueductal gray, left thalamus, and left cingulate gyrus. The activation map of group 1 was similar to healthy controls. CONCLUSIONS: Our results support the hypothesis that distinct supraspinal activation patterns exist between female MS patients with VD and those without.

Characterization of functional brain connectivity towards optimization of music selection for therapy: a fMRI study.

Background: Music therapy, a nontraditional approach to patient care, has long been used to achieve a wide variety of positive results. To deepen our understanding of the connection and therapeutic potential of music, the effect of music therapy and music medicine (music administered to individuals without an interactive therapeutic relationship) on the brain remains a topic of active research. Objective: This study is aimed at investigating the effect of different music genres and individualized music selection on brain functional connectivity (FC) measured by functional magnetic resonance imaging (fMRI). Methods: Twelve healthy subjects listened to five excerpts: Bach with and without visual guide (unfamiliar), self-selected familiar music, Gagaku (unfamiliar music) and Chaplin (spoken word) while undergoing a block design fMRI study. fMRI datasets were imported into CONN (Matlab toolbox) and graph networks were created for 132 anatomical regions in MNI space. Group connectivity for each soundtrack was quantified and statistically analyzed using the R package. Results: Complex interactions between brain regions, cerebellar regions (713), superior frontal gyrus (178) and parahippocampus (223), were highest for self-selected music. Brain regions involving sound processing, memory retrieval, semantic processing and motor areas were continuously activated for all five excerpts; however, most connections were formed in language processing regions for the Bach excerpt. Conclusion: Functional brain connectivity varied by soundtrack with the largest degree of connectivity found consistently for self-selected and unfamiliar (Bach, Gagaku) music. Incorporating individualized music listening into existing therapy paradigms may positively contribute to standard protocol for stroke rehabilitation and prevention.