Background: Positive effect on pelvic floor muscle training (PFMT) has been reported in poststroke patients with neurogenic lower urinary tract dysfunction (NLUTD). The effects were measured by bladder diary, pelvic floor muscle function, lower urinary tract symptoms, sexuality, and quality of life. However, measurement on brain activity seems to be missing.
Objective: To identify studies which report brain activity measured by functional magnetic resonance imaging (fMRI) as a response to voluntary pelvic floor muscles (PFMs) contractions and PFMT.
Methods: A literature search in which six databases was screened for this review.
Results: Fourteen studies were identified all published during 2005 - 2020. Twelve studies reported data of brain activity as a response to voluntary PFMs contractions and two as a response to PFMT. The participants (n=277) were respectively healthy adults (n=172, 62%), males with prostate cancer (n=22, 8%), females with stress urinary incontinence (n=10, 4%), older women with urge urinary incontinence (n=62, 22%), and Multiple sclerosis (MS) patients with detrusor sphincter dyssynergia (n=11, 4%). No studies in stroke patients were identified.
All identified studies focused primarily on the cerebral control of micturition circuit, whereas the brain activity as response to voluntary PFMs contractions only played a role in the investigations.
Conclusions: The identified studies indicate that fMRI even provide valuable outcome data supporting clinical outcome data and provide knowledge of the underlying mechanisms in the brain and its control of the bladder by PFMs contractions and PFMT. However, no studies in stroke patients were identified.
There is a call for studies using fMRI, providing knowledge of the brain activity as a response to voluntary PFMs contractions and PFMT in stroke patients with NLUTD.
Brain activity, fMRI, Neurogenic lower urinary tract dysfunction, Outcome, Pelvic floor muscle training, Stroke