# High-resolution mapping of the human brainstem during continence and micturition: noninvasive in vivo 7 Tesla fMRI study

> **NIH NIH R03** · METHODIST HOSPITAL RESEARCH INSTITUTE · 2022 · $120,511

## Abstract

The lower urinary tract (LUT) – bladder, bladder neck, urethra, and urethral sphincter – is controlled by a complex
neural network. A delicate and complex switch/relay exists between storage of urine (continence) and voluntary
voiding (micturition) and, in humans, control over this switch is located in the brainstem regions known as the
pontine storage center (PSC), the pontine micturition center (PMC) and the periaqueductal gray (PAG). Over the
last two decades, despite significant research in the brain control of LUT, our understanding of the brainstem in
humans has remained rudimentary. 7Tesla magnetic resonance imaging (MRI) has demonstrated improved
ability for mapping of the brainstem, a region historically posing challenges to obtain fMRI data due to its
location close to many large arteries and ventricles, yet encompassing some of the most important regions of
the bladder cycle, such as the PAG, PSC and PMC (Regions of Interest-RoIs for this study) highlighting the
significance and the priority of this proposed research.
The overall objective of this proposal is to use a noninvasive fMRI protocol that allows for evaluation of the
brainstem during continence and micturition in real-time, using high-resolution neuroimaging (7T fMRI) in both
men and women with the following two specific aims: Aim 1: Assessing activation patterns of brainstem RoIs
during continence and micturition within and between cohorts of healthy men and women; and Aim 2: Comparing
activation patterns of brainstem RoIs obtained in Aim 1 to our previous data from Multiple Sclerosis (MS) patients
obtained on 3T and 7T MRI supported by my current K23 award. The proposed R03 project is a prospective two-
year human trial that includes a novel and noninvasive micturition fMRI paradigm evaluating the brainstem at
rest with empty bladder and with full bladder following accelerated hydration (noninvasive bladder filling by
consuming water) and micturition using 7T fMRI in healthy men and women. Over the past five years, my
research team has established a 3T fMRI brain-bladder platform and have successfully used it in healthy
controls, patients with LUTD, including MS, and men with Benign Prostatic hyperplasia. I have the appropriate
resources, collaboration, experience and expertise to complete the proposed study in time and within budget.
Currently, I am in my final two years of her K23 Mentored Patient-Oriented Research Career Development Award
from NIDKK and have successfully executed and published on aims 1 and 2 of my K23 proposal (Aim 3 is
ongoing and with projected completion in 2021). This proposed R03 study will be the first 7T MRI study
evaluating the brain and specifically brainstem control over LUT, creating the seminal 7 T database for future
studies in patients with LUTD and providing a more accurate roadmap for potential therapeutic and
neuromodulation options. The results from this study will complement my research to prepare strong preliminary
data for future R0...

## Key facts

- **NIH application ID:** 10330466
- **Project number:** 5R03DK126994-02
- **Recipient organization:** METHODIST HOSPITAL RESEARCH INSTITUTE
- **Principal Investigator:** Rose Khavari
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $120,511
- **Award type:** 5
- **Project period:** 2021-01-18 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10330466

## Citation

> US National Institutes of Health, RePORTER application 10330466, High-resolution mapping of the human brainstem during continence and micturition: noninvasive in vivo 7 Tesla fMRI study (5R03DK126994-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10330466. Licensed CC0.

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