Bladder-Brain Link May Point to Better Treatments for Sleep, Attention Problems

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Bladder problems may leave a mark on the brain, by changing patterns of brain activity, possibly contributing to disrupted sleep and problems with attention. For one in six Americans who have overactive bladder, the involuntary bladder contractions that often trigger more frequent urges to urinate, such mind-body connections may be of more than academic interest.

“We often tend to focus on just one organ, but here we see how an abnormal organ affects the whole organism,” said behavioral scientist Rita J. Valentino, Ph.D., of The Children’s Hospital of Philadelphia, who led the research describing how an overactive bladder altered nervous system activity in animals.

The study appeared in the July 21 online edition of the Proceedings of the National Academy of Sciences.

Overactive bladder, while it occurs in a variety of conditions in both adults and children, is especially prevalent among elderly men, in whom an enlarged prostate gland partially obstructs the flow of urine and makes bladder muscles contract involuntarily. Valentino’s research team mimicked the condition in an animal model by surgically constricting the outlet of urine from rats’ bladders.

Building on their previous investigations of the neural circuits between the bladder and the brain, the researchers found that two small brain structures, the Barrington’s nucleus and the locus ceruleus, developed abnormal activity as a result of the bladder obstruction. In particular, the locus ceruleus showed persistently high activity, and this resulted in an abnormal electroencephalogram (EEG) recorded from the cortex, the broad mass of the brain that governs higher-level functions. In people, abnormally high activity in the cortex may result in disordered sleep, anxiety and difficulty in concentrating.

Valentino said further studies are necessary to analyze the direct connections between heightened brain activity and specific behaviors, but added that the brain circuits involving the locus ceruleus might be a useful target for drugs to improve attention and sleep patterns in patients with bladder dysfunctions.

Furthermore, she added, in addition to overactive bladder, other visceral diseases, such as irritable bowel disorder, may also affect the same neural circuitry, with similar neurobehavioral consequences.

The National Institutes of Health provided grant support for this research. Valentino’s co-authors, all from The Children’s Hospital of Philadelphia, were Stephen A. Zderic, M.D.; Elizabeth Rickenbacher, Madelyn A. Baez, Lyman Hale, and Steven C. Leiser.

About The Children’s Hospital of Philadelphia: The Children’s Hospital of Philadelphia was founded in 1855 as the nation’s first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children’s Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking third in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents.

Source: Children’s Hospital of Philadelphia

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