[Micturition and cognition]

Abstract

Purpose: The physiopathology of the voiding and urinary continence was one of the hot topic of research these last few years. Unfortunately, anyone have already found a unique cause which could explain urinary incontinence (urge or stress). The concept of cognitive function highlights new ways of research to show the fundamental role of the cortex and the sub-cortex in these diseases.

Methods: A comprehensive literature review using Pubmed, Medline, Embase and Cochrane: "cognition, urinary tract, urinary continence, neuroimaging, IRMf, micturition, urge, brain factor and cognitive therapy". In all the articles, 72 really dealt with micturition and cognition.

Results: New imaging techniques allowed to show the relationship between the different brain area involved in the bladder control such as the periaqueductal gray, the hypothalamus, the insula, the anterior cingulated cortex and the prefrontal cortex. These cortical area are equally involved in cognition. An alteration of urinary continence implies a modification of activation of these cortical areas.

Conclusion: A better knowledge of the cognitive side of micturition and urinary continence will allow to improve the treatment of their associated diseases.

Keywords: Brain factor; Cognition; Cognitive therapy; Facteur cognitif; Incontinence urinaire; Neuroimagerie; Neuroimaging; Thérapie cognitive; Urge; Urgenturie; Urinary continence.