Changes of Detrusor Function in Patients with Frontal Lobe Lesion

Lee, Dong Gi; Kim, Eui Jong; Lee, Sun Ju

Abstract

PURPOSE
The frontal lobe is the highest center of importance in the control of micturition. Patients with frontal lobe lesion have detrusor hyperreflexia, detrusor areflexia or uninhibitory urethral relaxation. However, the precise regions controlling the detrusor activity have not been established. Therefore, we analogize the regions of the frontal lobe controlling micturition by means of analyzing the detrusor change of patient with frontal lobe lesion.
MATERIALS AND METHODS
The cystometric findings of twenty-two patients, who had frontal lobe lesions bun don't any other causes of a neurogenic bladder, were analyzed. And the frontal lobe lesions were classified by magnetic resonance imaging into seven lesions(the olfactory frontal center, gyrus recti, cingulate gyrus, inferior frontal gyrus, medial frontal gyrus, superior frontal gyrus, and precentral gyrus). RESULTS: In the urodynamic study, 11 patients showed detrusor overactivity(40.0%), 2 normal findings(14.7%) and 8 detrusor areflexia(36.3%). In the detrusor hyperreflexia group, high involvement of the medial frontal gyrus 63.6%, superior frontal gyrus(54.5%) and precentral gyrus(54.5%) were observed. In the detrusor areflexia group, the medial frontal gyrus 62.5%, superior frontal gyrus 37.5%, and precentral gyrus 62.5% were also more involved. CONCLUSION: The patients with detrusor hyperreflexia and detrusor areflexia have high incidences of precentral gyrus and medial frontal gyrus involvement. This implies that the superior surface of the frontal lobe(precentral gyrus and medial frontal gyrus) might be associated with the inhibitory reflex of micturition and detrusor contractibility.