Alterations in resting state oscillations and connectivity in sensory and motor networks in women with interstitial cystitis/painful bladder syndrome.
Alterations in resting state oscillations and connectivity in sensory and motor networks in women with interstitial cystitis/painful bladder syndrome.
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DOI：
10.1016/j.juro.2014.03.093
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发表时间：
2014-09
影响因子：
6.6
通讯作者：
Mayer, Emeran A.
中科院分区：
文献类型：
--
作者：
Kilpatrick, Lisa A.;Kutch, Jason J.;Tillisch, Kirsten;Naliboff, Bruce D.;Labus, Jennifer S.;Jiang, Zhiguo;Farmer, Melissa A.;Apkarian, A. Vania;Mackey, Sean;Martucci, Katherine T.;Clauw, Daniel J.;Harris, Richard E.;Deutsch, Georg;Ness, Timothy J.;Yang, Claire C.;Maravilla, Kenneth;Mullins, Chris;Mayer, Emeran A.
间质性膀胱炎/膀胱疼痛综合征（IC/PBS）的病理生理机制尚不完全清楚，但被认为与疼痛和内脏感觉信号处理中的中枢障碍有关。我们的目的是确定女性IC/PBS患者与健康对照者之间大脑活动和连通性的差异，以推进IC/PBS的临床表型和治疗工作。作为多学科方法研究慢性盆腔疼痛（MAPP）研究网络*项目的一部分，我们在10分钟静息fMRI扫描期间收集了大量表型良好的女性IC/PBS患者和女性健康对照者的内在脑活动振荡动力学。将BOLD信号变换到频域，计算多个频段的相对功率。结果表明，内脏感觉区（脑岛后）和感觉运动皮质（中枢后回、中央旁小叶、辅助运动区）的频率分布发生了变化，其中包括一个可能参与控制盆底肌肉的区域（PelMotor）。此外，SMA、中央旁小叶和PelMotor都显示出与中脑（红核）和小脑的功能连接增加。这种功能连接的增加在膀胱充盈疼痛的患者中表现得最为明显。这些研究结果表明，患有IC/PBS的女性在其病理中具有神经运动成分，涉及先前与膀胱功能相关的皮质-小脑网络内固有振荡和连通性的改变。
The pathophysiology of interstitial cystitis/painful bladder syndrome (IC/PBS) remains incompletely understood, but is thought to involve a central disturbance in the processing of pain and viscerosensory signals. We aimed to identify differences in brain activity and connectivity between female IC/PBS patients and healthy controls in order to advance clinical phenotyping and treatment efforts for IC/PBS. We examined oscillation dynamics of intrinsic brain activity in a large sample of well-phenotyped female IC/PBS patients and female healthy controls collected during a 10-minute resting fMRI scan as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network* project. The BOLD signal was transformed to the frequency domain and relative power was computed for multiple frequency bands. The results demonstrated altered frequency distributions in a viscerosensory region (post Insula) and sensorimotor cortices (postcentral gyrus, paracentral lobule, supplementary motor area (SMA), including a region likely involved in control of pelvic floor muscles (PelMotor). Additionally, the SMA, paracentral lobule and PelMotor all demonstrated increased functional connectivity to the midbrain (red nucleus) and cerebellum. This increased functional connectivity was greatest in patients reporting pain during bladder filling. These findings suggest that women with IC/PBS have a neuromotor component to their pathology involving an alteration in the intrinsic oscillations and connectivity within a cortico-cerebellar network previously associated with urinary bladder function.
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