Abstract
Background: Primary monosymptomatic nocturnal enuresis (PMNE) is a common disorder among school-age children. Previous research has suggested that the prefrontal cortex (PFC) is essential to maintain urine storage in bladder control. We hypothesized that children with PMNE have functional deficits in several brain regions, especially the PFC, during urine storage. In this work, we investigated 30 children with PMNE and 28 controls in a state of natural urine holding to evaluate dysfunction in the bladder control network by applying degree centrality (DC) analysis methods based on resting-state functional magnetic resonance imaging. And seed-based functional connectivity (FC) analysis was used to investigate whether the dysfunctional areas exhibited altered FC with other brain regions.Results: Compared with the typical healthy children, the children with PMNE showed increased DC in the right inferior frontal gyrus (IFG). Also, the right IFG showed increased connectivity with the left middle and inferior frontal gyri and the right precuneus extending to the cuneus in the children with PMNE.Conclusion: The children with PMNE showed abnormal neural activity during urine storage and exhibited increased DC in the right IFG and increased connectivity with the left PFC and right precuneus during urine storage. These results suggest that compensatory effects may be associated with the right IFG combined with the precuneus and left PFC working together to maintain high vigilance and improve micturition's inhibition function to preserve the state of urine holding in children with PMNE.
Pediatric Tuina (massage) for primary monosymptomatic nocturnal enuresis
