PhD defence Susana Fernandez Chadily

Keywords: Bladder control, Periaqueductal gray, Overactive bladder, MRI / brain imaging

"Decoding the Brain–Bladder Axis: Functional Mapping of Brainstem Pathways in Lower Urinary Tract Control"

Problems with bladder control, such as sudden urgency, frequent urination and urine leakage, can strongly affect daily life, sleep and social activities. Although these symptoms are often linked to the bladder itself, the brain also plays an important role. In overactive bladder, treatment is still largely based on symptoms, while objective markers that explain the underlying cause or predict treatment success are lacking.

This PhD research investigated how the brain contributes to bladder control, with a particular focus on a small brainstem region called the periaqueductal gray. Using ultra-high-field brain imaging, the research mapped how this region is functionally organized and how its communication patterns change with bladder state. The findings also found that these brain networks behave differently in people with overactive bladder, suggesting that altered processing in the brain may contribute to their symptoms.

These findings provide new insight into the brain–bladder connection and may contribute to the future development of brain-based markers for diagnosis, treatment monitoring and more personalized treatments for bladder disorders.

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