Research Article Quantitative Changes in Cerebral Perfusion during Urinary Urgency in Women with Overactive Bladder Nisha G. Arya, 1 Steven J. Weissbart, 2 Sihua Xu, 3 Rupal Bhavsar, 3 and Hengyi Rao 3 1 Department of Obstetrics and Gynecology, Perelman School of Medicine, Te University of Pennsylvania, Philadelphia, PA, USA 2 Department of Urology, Stony Brook School of Medicine, Stony Brook, NY, USA 3 Center for Functional Neuroimaging, Department of Neurology, Perelman School of Medicine, Te University of Pennsylvania, Philadelphia, PA, USA Correspondence should be addressed to Nisha G. Arya; aryanisha2000@gmail.com Received 18 May 2017; Accepted 16 July 2017; Published 17 August 2017 Academic Editor: Nader Pouratian Copyright © 2017 Nisha G. Arya et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. To quantitatively measure changes in cerebral perfusion in select regions of interest in the brain during urinary urgency in women with overactive bladder (OAB) using arterial spin labeling (ASL). Methods. Twelve women with OAB and 10 controls underwent bladder flling and rated urinary urgency (scale 0–10). ASL fMRI scans were performed (1) in the low urgency state afer voiding and (2) high urgency state afer drinking oral fuids. Absolute regional cerebral blood fow (rCBF) in select regions of interest was compared between the low and high urgency states. Results. Tere were no signifcant diferences in rCBF between the low and high urgency states in the control group. In the OAB group, rCBF (mean ± SE, ml/100 g/min) increased by 10–14% from the low to the high urgency state in the right anterior cingulate cortex (ACC) (44.56 ± 0.59 versus 49.52 ± 1.49,  < 0.05), lef ACC (49.29 ± 0.85 versus 54.02 ± 1.46,  < 0.05), and lef insula (50.46 ± 1.72 versus 54.99 ± 1.09,  < 0.05). Whole-brain analysis identifed additional areas of activation in the right insula, right dorsolateral prefrontal cortex, and pons/midbrain area. Conclusions. Urinary urgency is associated with quantitative increase in cerebral perfusion in regions of the brain associated with processing emotional response to discomfort. 1. Introduction Urinary urgency, a sudden compelling desire to urinate that is difcult to defer, is the main symptom of overactive bladder (OAB), a functional disorder of bladder storage characterized by the symptoms of urinary urgency, usually associated with frequency and nocturia [1]. OAB afects approximately 15% of US women and prevalence rates are higher in women than men [2]. Common treatment options for OAB, such as behavioral and pharmacologic therapy, have limited efcacy [3]. Te development of more efcacious treatment for OAB has been limited by a lack of understanding of the underlying pathogenesis of OAB. While bladder outlet obstruction caused by prostatic enlargement is a common cause of OAB in men, anatomic abnormalities of the urinary bladder have not been identifed in women. Brain imaging studies in a related functional bowel disorder, irritable bowel syndrome, have identifed abnormalities in the processing of interoceptive stimuli in the brain [4]. A similar abnormality in processing of aferent signals may exist in women with OAB also. In meta-analyses of brain imaging studies, majority performed using BOLD fMRI, we and other authors have previously reported that urinary urgency is associated with activation of several cortical and subcortical regions that comprise the limbic system, that is, region of the brain that processes emotional response to pain and discomfort, such as anterior cingulate cortex (ACC), insula, and prefrontal cortex (PFC) [5, 6]. However, the magnitude of activation in these regions has not been measured; thus the precise relationship between urinary urgency and the limbic cortex remains unclear. Neural activity in the brain is tightly coupled with regional cerebral blood fow (rCBF). Arterial spin labeling (ASL) is a fMRI technique that allows quantitative measure- ment of absolute cerebral perfusion [7]. Unlike PET scans that require the administration of radioactive intravenous Hindawi BioMed Research International Volume 2017, Article ID 2759035, 8 pages https://doi.org/10.1155/2017/2759035