Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, April 2, 2015

Brain Mechanisms Underlying Urge Incontinence and its Response to Pelvic Floor Muscle Training

This took me a while to get under control. I absolutely hated having to figure out where the bathrooms were anytime I entered a new building.  Road trips were hell. I guess men do not have this problem.
http://www.sciencedirect.com/science/article/pii/S0022534715035661

Abstract

Aims

Urge urinary incontinence (UUI) is a major problem, especially in the elderly, and the underlying mechanisms of disease and therapy are unknown. We used biofeedback-assisted pelvic floor muscle training (PFMT) and functional brain imaging (fMRI) to investigate cerebral mechanisms, aiming to improve understanding of brain-bladder control and therapy.

Methods

Before receiving PFMT, functionally intact, older, community-dwelling women with UUI—as well as normal controls—underwent comprehensive clinical and bladder-diary evaluation, urodynamic testing, and brain fMRI; the evaluation was repeated post-PFMT in those with UUI. fMRI was used to determine brain reaction to rapid bladder filling with urgency.

Results

28 of 65 UUI subjects responded to PFMT with >50% improvement of UUI frequency on diary. However, responders and non-responders displayed 2 different patterns of brain reaction. Pattern 1 (Responders): pre-PFMT, the dorsal anterior cingulate cortex (dACC) and adjacent supplementary motor area (SMA) were activated as was the insula. Following PFMT, dACC/SMA activation diminished, and there was a trend to mPFC deactivation. Pattern 2 (non-responders): pre-PFMT, the medial prefrontal cortex (mPFC) was deactivated and this changed little following PFMT.

Conclusions

In older women with UUI, there appear to be two patterns of brain reaction to bladder filling and they seem to predict response and non-response to PFMT. Moreover, diminished cingulate activation appears to be a consequence of PFMT-induced UUI improvement, whereas prefrontal deactivation may be a mechanism contributing to success of PFMT. In non-responders this latter mechanism is unavailable; this may explain why another form of therapy is required.

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