Novel and Established Neuroimaging Modalities in Neurogenic Lower Urinary Tract Dysfunction

Abstract Purpose of Review Neurogenic lower urinary tract dysfunction (NLUTD) is a condition characterized by bladder or urinary sphincter control issues due to neurologic dysregulation. NLUTD commonly causes symptoms like urinary incontinence and retention that impact both urinary health and quality of life. Current NLUTD treatment primarily manages symptoms, as restorative interventions are limited by a lack of diagnostic approaches to understand its underlying neurologic mechanisms. Neuroimaging may help identify neurologic pathways associated with bladder control, providing insights into functional and structural neural changes in NLUTD. This report reviews current neuroimaging modalities and their efficacy in detecting NLUTD. Recent Findings Evaluated modalities include functional magnetic resonance imaging, positron emission tomography, functional near-infrared spectroscopy, functional ultrasonography, electrocorticography, and deep brain stimulation. Each modality’s unique characteristics, such as resolution and invasiveness, shape its application in studying neurologic mechanisms of NLUTD. Collectively, they reveal a consistent finding: reduced brain activation in circuits related to bladder voiding and storage in patients with NLUTD. Summary By examining each method’s mechanism, effectiveness, advantages, and limitations, we aim to aid clinicians and researchers in selecting the best techniques for exploring the mechanisms of NLUTD and developing restorative treatments.