Abstract: For successful micturition (urinary voiding) to occur, the bladder must contract whilst the urethral sphincter simultaneously relaxes to enable urine to be expelled.  A spino-midbrain-spinal micturition circuit is engaged to co-originate the event, which occurs only when the individual judges it is safe and socially acceptable to do so, implying that the control network can be switched on and off at will. In patients with urge incontinence characterized by “a sudden and compelling desire to void that is difficult to defer” the network may be faulty. Using a rat model we will show that the functional integrity of neuronal networks in the midbrain periaqueductal grey (PAG) is key to successful voiding. On the other hand, electrical stimulation within the PAG inhibits voiding, both in rat models and also in human patients with deep brain electrodes chronically implanted into the PAG. This proof of concept study opens the possibility of developing closed loop deep brain stimulation to regulate bladder emptying in patients with urge incontinence of central origin.

Bio: Thelma Lovick graduated in Physiology from the University of Manchester, UK before moving to the University of Birmingham, UK to complete her doctoral training.  She spent most of her career at Birmingham where she combined teaching with research, becoming Reader in Neuroscience in 2000. In 2012 she moved her lab to the University of Bristol where she now concentrates full time on research. As an in vivo neurophysiologist working on animal models, she focused on studying neural control systems involved in regulating reactivity to pain and autonomic responsiveness and the association between these systems in normal and pathophysiological states. She is also developed an interest in the mechanisms by which cyclical changes in female sex hormones influence these systems and how hormones impact on behavior of females, a line of research she now pursues in Brazil during the British winter! About 5 years ago she turned her attention to the central nervous pathways that control urinary continence. She defined a key midbrain area, whose activity is critical for normal control of bladder function and showed that manipulation of the midbrain network by deep brain stimulation can be used to control bladder emptying in rats. Importantly, working with clinical colleagues at the University of Oxford, she demonstrated how this procedure may be translated into humans to control urinary continence.

~BME Faculty Host: Pedro Irazoqui~

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