Scalp Topography of Lower Urinary Tract Sensory Evoked Potentials
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ORIGINAL PAPER
Scalp Topography of Lower Urinary Tract Sensory Evoked Potentials Stéphanie van der Lely1 · Thomas M. Kessler1 · Ulrich Mehnert1 · Martina D. Liechti1 Received: 4 October 2019 / Accepted: 1 September 2020 / Published online: 16 October 2020 © The Author(s) 2020
Abstract Impaired lower urinary tract (LUT) afferents often cause LUT symptoms. Assessment of LUT afferent pathways is possible using bipolar cortical sensory evoked potential (SEP) recordings with the active electrode at the vertex during electrical stimulation in the LUT. This study aimed to investigate the topographical distribution and microstates of lower urinary tract sensory evoked potentials (LUTSEPs) using different stimulation frequencies. Ninety healthy subjects (18–36 years old, 40 women) were randomly assigned to one of five stimulation locations [bladder dome; trigone; proximal, membranous (men only) or distal urethra]. Cycles of 0.5 Hz/1.1 Hz/1.6 Hz electrical stimulation were applied using a custom-made catheter. Cortical activity was recorded from 64 surface electrodes. Marker setting was performed manually on an individual subjectlevel for the P1, N1, and P2 components of vertex recordings. N1 and P2 topographies presented with central negativities and positivities around the vertex. Regarding topographical distribution, Randomization Graphical User interface (RAGU) analyses revealed consistent frequency effects and microstates for N1/P2. Higher stimulation frequencies resulted in decreasing map strength for P1, N1, and P2. LUTSEP topographies suggest central generators in the somatosensory cortex, which are not detectable in a bipolar set-up. The observed frequency effect indicates fiber refractoriness at higher frequencies. The multichannel approach allows more comprehensive assessment of LUTSEPs and might therefore be sensitive to pathological changes. Examinations in patients with LUT symptoms are needed to further investigate this biomarker. Keywords Brain mapping · Electroencephalography · Electrical stimulation · Evoked potentials · Afferent pathways · Lower urinary tract Abbreviations BD Bladder dome CNV Contingent negative variation dUR Distal urethra EEG Electroencephalography GFP Global field power HADS Hospital Anxiety and Depression Scale
Handling Editor: Christoph M. Michel . Ulrich Mehnert and Martina D. Liechti are the joint senior authors Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10548-020-00796-z) contains supplementary material, which is available to authorized users. * Martina D. Liechti [email protected] 1
Department of Neuro‑Urology, Balgrist University Hospital, University of Zürich, Forchstrasse 340, 8008 Zürich, Switzerland
ICIQ-FLUTS International Consultation on Incontinence Modular Questionnaire Female lower urinary tract symptoms ICIQ-MLUTS International consultation on Incontinence Modular Questionnaire Male lower urinary tract symptoms IPSS International Prostate Symptom Score LMM Linear mixed models LUT
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