Brain functional and anatomical changes in chronic prostatitis/chronic pelvic pain syndrome.
Brain functional and anatomical changes in chronic prostatitis/chronic pelvic pain syndrome.
复制标题
DOI：
10.1016/j.juro.2011.03.027
复制
发表时间：
2011-07
期刊：
影响因子：
--
通讯作者：
Schaeffer AJ
中科院分区：
文献类型：
--
作者：
Farmer MA;Chanda ML;Parks EL;Baliki MN;Apkarian AV;Schaeffer AJ
慢性前列腺炎/慢性盆腔疼痛综合征的病理生理学研究主要集中在外周功能障碍的标志物。我们提出了第一个神经影像学调查，我们的知识，以表征慢性前列腺炎/慢性盆腔疼痛综合征的脑功能和解剖。我们收集了19例慢性前列腺炎/慢性骨盆疼痛综合征男性患者的数据，以及16名年龄和性别匹配的健康对照。从14名慢性前列腺炎/慢性盆腔疼痛综合征患者中获得功能性磁共振成像数据，因为他们在扫描仪内评定自发性疼痛。使用基于体素的形态测量法评价灰质总体积和区域密度的组间差异（每组16例患者），并使用扩散张量成像研究白色物质完整性以测量分数各向异性。功能和解剖成像结果与慢性前列腺炎/慢性盆腔疼痛综合征的临床特征相关。自发性盆腔疼痛的独特特征是右前角的功能激活，与临床疼痛强度相关。区域灰质体积无组间差异，但疼痛相关区域（前额叶和前扣带回）的灰质密度与疼痛强度和疼痛慢性程度呈正相关。此外，白色物质各向异性和新皮质灰质体积之间的相关性在慢性前列腺炎/慢性骨盆疼痛综合征中被破坏。我们提供了新的证据表明，慢性前列腺炎/慢性盆腔疼痛综合征的疼痛与慢性盆腔疼痛综合征的功能性脑激活和脑解剖重组的特定模式有关。这些发现需要进一步研究中枢机制在慢性前列腺炎/慢性盆腔疼痛综合征的启动和维持中的作用。
Research into the pathophysiology of chronic prostatitis/chronic pelvic pain syndrome has primarily focused on markers of peripheral dysfunction. We present the first neuroimaging investigation to our knowledge to characterize brain function and anatomy in chronic prostatitis/chronic pelvic pain syndrome. We collected data from 19 male patients with chronic prostatitis/chronic pelvic pain syndrome, and 16 healthy age and gender matched controls. Functional magnetic resonance imaging data were obtained from 14 patients with chronic prostatitis/chronic pelvic pain syndrome as they rated spontaneous pain inside the scanner. Group differences (16 patients per group) in gray matter total volume and regional density were evaluated using voxel-based morphometry, and white matter integrity was studied with diffusion tensor imaging to measure fractional anisotropy. Functional and anatomical imaging outcomes were correlated with the clinical characteristics of chronic prostatitis/chronic pelvic pain syndrome. Spontaneous pelvic pain was uniquely characterized by functional activation within the right anterior insula, which correlated with clinical pain intensity. No group differences were found in regional gray matter volume, yet density of gray matter in pain relevant regions (anterior insula and anterior cingulate cortices) positively correlated with pain intensity and extent of pain chronicity. Moreover the correlation between white matter anisotropy and neo-cortical gray matter volume was disrupted in chronic prostatitis/chronic pelvic pain syndrome. We provide novel evidence that the pain of chronic prostatitis/chronic pelvic pain syndrome is associated with a chronic pelvic pain syndrome specific pattern of functional brain activation and brain anatomical reorganization. These findings necessitate further investigations into the role of central mechanisms in the initiation and maintenance of chronic prostatitis/chronic pelvic pain syndrome.