Background: The etiology of overactive bladder (OAB) remains unclear. Observed neurogenic factors in the literature are limited to suprapontine or spinal pathologies. The blink reflex is a useful tool in the evaluation of brainstem functions. Blink reflex latency times were evaluated in order to reveal pathology in the brainstem. Methods: A total of 60 women, 30 patients with idiopathic OAB and 30 healthy controls, were enrolled in the study. Blink reflex latency times were analyzed by electrical stimulation of the supraorbital nerve. Two responses in the orbicularis oculi muscle, early ipsilateral response (R1) and late bilateral response (R2) latency times, were recorded. Results: Mean ages of the patients and controls were 51.9 ± 5.3 and 49.2 ± 6.2 years, respectively. R2 latency times were significantly higher in patients than in controls. However, R1 latency times were similar between the two groups. Conclusions: The results of the study suggest a significant relation between late blink latency times and OAB. An oligosynaptic path via the trigeminal nuclei is responsible for R1; however, R2 response is relayed through the reticular formation. Stimulation of pontine reticular formation inhibits micturition contraction. In some patients, idiopathic OAB may result from reticular formation-originated pathology. Additional studies on other reticular formation-mediated reflexes are needed to reveal possible dysfunction of reticular formation.

Griffiths D, Tadic SD, Schaefer W, et al: Cerebral control of the bladder in normal and urge-incontinent women. Neuroimage 2007;37:1-7.
Kuipers R, Mouton LJ, Holstege G: Afferent projections to the pontine micturition center in the cat. J Comp Neurol 2006;494:36-53.
Yokoyama O, Komatsu K, Ishiura Y, et al: Overactive bladder - experimental aspects. Scand J Urol Nephrol Suppl 2002;210:59-64.
Kimura J, Powers JM, Van Allen MW: Reflex response of orbicularis oculi muscle to supraorbital nerve stimulation. Arch Neurol 1969;21:193-199.
Shahani BT, Young RR: Human orbicularis oculi reflexes. Neurology 1972;22:149-154.
Kimura Y, Ukai Y, Kimura K, et al: Inhibitory influence from the nucleus reticularis pontis oralis on the micturition reflex induced by electrical stimulation of the pontine micturition center in cats. Neurosci Lett 1995;195:214-216.
Blok BFM, Holstege G: The central nervous system control of micturition in cats and humans. Behav Brain Res 1998;92:119-125.
Kavia RBC, Dasgupta R, Fowler CJ: Functional imaging and the central control of the bladder. J Comp Neurol 2005;493:27-32.
Ennever JB, Horn AKE: Reticular formation: eye movements, gaze, and blinks; in Paxinos G, Mai JK (eds): The Human Nervous System. Elsevier, 2004, pp 479-510.
Holstege G: Descending motor pathways and the spinal motor system: limbic and nonlimbic components. Prog Brain Res 1991;87:307-421.
Aramideh M, Ongerboer de Visser BW: Brainstem reflexes: electrodiagnostic techniques, physiology, normative data, and clinical applications. Muscle Nerve 2002;26:14-30.
Abrams P, Cardozo L, Fall M, et al: The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology 2003;61:37-49.
Coyne KS, Margolis MK, Zyczynski T, Elinoff V, Roberts R: Validation of an overactive bladder screener in a primary care patient population in the United States. Poster presented at the 34th Joint Meeting of the International Continence Society and the International UroGynecological Association, August 23-27, 2004, Paris, France.
Dauvergne C, Smit AE, Valla J, et al: Are locus coeruleus neurons involved in blinking? Neurosci Res 2008;61:182-191.
Nazlıel B, Arıkan Z, Irkeç C, et al: Blink reflex abnormalities in chronic alcoholics. Eur Neurol 2004;52:82-86.
Holstege G, Tan J, van Ham JJ, et al: Anatomical observations on the afferent projections to the retractor bulb motoneuronal cell group and other pathways possibly related to the blink reflex in the cat. Brain Res 1986;374:321-334.
Holstege G, van Ham JJ, Tan J: Afferent projections to the orbicularis oculi motoneuronal cell group. An autoradiographical tracing study in the cat. Brain Res 1986;374:306-320.
Sakakibara R, Nakazawa K, Shiba K, et al: Firing patterns of micturition-related neurons in the pontine storage centre in cats. Auton Neurosci 2002;99:24-30.
Mays LE, Morisse DW: Electrical stimulation of the pontine omnipause area inhibits eye blink. J Am Optom Assoc 1995;66:419-422.
Griffiths D, Holstege G, Dalm E, et al: Control and coordination of bladder and urethral function in the brainstem of the cat. Neurourol Urodyn 1990;9:63-82.
Ongerboer de Visser BW: Anatomical and functional organization of reflexes involving the trigeminal system in man: jaw reflex, blink reflex, corneal reflex and exteroceptive suppression. Adv Neurol 1983;39:729-738.
Sibony PA, Evinger C: Normal and abnormal eyelid function; in Miller NR, Newman NH (eds): Clinical Neuro-Ophthalmology. Baltimore, Williams & Wilkins, 1998, pp 1509-1592.
Ongerboer de Visser BW, Kuypers HGJM: Late blink reflex changes in lateral medullary lesions. An electrophysiological and neuroanatomical study of Wallenberg's syndrome. Brain 1978;101:285-294.
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