Distributed brain-spinal cord dynamics during micturition revealed by functional ultrasound imaging

Micturition relies on coordinated activity across distributed neural circuits spanning the brain and spinal cord, yet the spatiotemporal dynamics of these processes remain poorly understood. Disruption of these pathways in conditions such as spinal cord injury, Parkinson′s disease, multiple sclerosis, and aging can lead to neurogenic bladder dysfunction. Here, we used functional ultrasound imaging (fUSI), a modality with high spatiotemporal resolution and single-trial sensitivity, to investigate central nervous system activity during micturition. In anesthetized rats undergoing controlled bladder filling and volitional voiding, we recorded power Doppler signals from either the brain or the lumbosacral spinal cord. We observed distinct, region-specific hemodynamic responses associated with micturition across multiple brain regions, including the thalamus, hypothalamus, midbrain, and neocortex – particularly sensorimotor and retrosplenial areas – as well as dorsal and ventral spinal cord circuits. Furthermore, population-level activity in these regions enabled accurate decoding of bladder pressure dynamics. These results provide a systems-level characterization of central nervous system activity during micturition and establish fUSI as a platform for developing neural interfaces to restore bladder control.