Urine Trouble: Alterations in Brain Function Associated with Bladder Pain.
Urine Trouble: Alterations in Brain Function Associated with Bladder Pain.
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DOI：
10.1016/j.juro.2015.10.198
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发表时间：
2016-07
期刊：
影响因子：
--
通讯作者：
Kolber BJ
中科院分区：
文献类型：
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作者：
Sadler KE;Kolber BJ
慢性膀胱疼痛是一种使人衰弱的疾病，通常伴有情感和自主神经功能的改变。许多与慢性膀胱疼痛相关的症状都是由中枢神经系统介导的。在这篇综述中，分析了临床前动物模型和人类神经影像研究的数据，并生成了理论上的脊髓上膀胱疼痛网络。使用 PubMed 和 Google Scholar 进行了全面的文献综述。相关评论、原始研究文章及其引用的参考文献在神经解剖学的基础上进行了总结和组织。以下脑位点是膀胱疼痛文献中最主要的位点：丘脑、臂旁核、大脑皮层、杏仁核、下丘脑、导水管周围灰质和延髓头端腹内侧区。这篇综述重点介绍了这些区域，讨论了膀胱疼痛期间每个区域发生的分子和生理变化。膀胱疼痛调节涉及复杂的大脑位点网络。研究这些大脑区域以及它们在从急性膀胱疼痛过渡到慢性膀胱疼痛期间所经历的变化将为患有慢性膀胱疼痛疾病的患者提供新的治疗策略，例如间质性膀胱炎/膀胱疼痛综合征（IC/BPS）和慢性前列腺炎/慢性盆腔疼痛综合征（CP/CPPS）。
Chronic bladder pain is a debilitating condition often accompanied by alterations in affective and autonomic function. Many of the symptoms associated with chronic bladder pain are mediated by the central nervous system. In this review, data from preclinical animal models and human neuroimaging studies were analyzed and a theoretical supraspinal bladder pain network was generated. A comprehensive literature review was performed using PubMed and Google Scholar. Relevant reviews, original research articles, and their cited references were summarized then organized on a neuroanatomical basis. The following brain loci are the most predominant in the bladder pain literature: thalamus, parabrachial nucleus, cerebral cortex, amygdala, hypothalamus, periaqueductal gray, and rostral ventromedial medulla. This review highlights each of these regions, discussing the molecular and physiological changes that occur in each during the context of bladder pain. A complex network of brain loci is involved in bladder pain modulation. Studying these brain regions and the changes they undergo during the transition from acute to chronic bladder pain will provide novel therapeutic strategies for those suffering from chronic bladder pain diseases such as interstitial cystitis/bladder pain syndrome (IC/BPS) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).