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Figure 3 | BMC Urology

Figure 3

From: Protocol for a prospective magnetic resonance imaging study on supraspinal lower urinary tract control in healthy subjects and spinal cord injury patients undergoing intradetrusor onabotulinumtoxinA injections for treating neurogenic detrusor overactivity

Figure 3

Scan paradigm of three different task-related functional MRIs (fMRIs). All task-related fMRIs identically start with a ‘baseline’ rest (60 s, no specific stimulus or task is performed), a ‘baseline’ rating (desire to void and level of pain), a short rest (jittered between 7 and 9 s in which blood oxygen level-dependent (BOLD) activation resulting from motor activity during the previous rating will return to baseline to avoid contamination of the following condition) and conclude with a ‘last’ rest (60 s, no specific stimulus or task is performed). All task-related fMRIs consist of eight repetitive blocks, each with either five (first and third fMRIs) or eight (second fMRI) conditions. (A) Conditions of the first task-related fMRIs: (1) automated infusion of 100 mL body warm saline, (2) plateau phase (bladder distention after infusion is perceived), (3) rating, (4) passive withdrawal to empty the bladder completely and (5) short rest. This task-related fMRI starts with an empty bladder. (B) Conditions of the second task-related fMRIs: (1) automated infusion of 100 mL warm saline, (2) plateau phase, (3) rating, (4) short rest, (5) automated withdrawal of 100 mL, (6) plateau phase (bladder distention after withdrawal is perceived), (7) rating and (8) short rest. *This task-related fMRI (B) starts with a high prefilled bladder volume, that is, the bladder will be filled with body warm saline until a persistent desire to void is present. (C) Conditions of the third task-related fMRIs: (1) automated infusion of 100 mL cold (4–8°C) saline, (2) plateau phase, (3) rating, (4) passive withdrawal to empty the bladder completely and (5) short rest. This task-related fMRI starts with an empty bladder.

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