Sensory Testing in Subjects with Interstitial Cystitis

描述(申请人提供)：对间质性膀胱炎(IC)的神经生物学和内脏疼痛机制的最新见解表明，与其他内脏疼痛综合征一样，IC可能与膀胱本身的痛觉过敏和来自膀胱的疼痛通路的中枢敏感化有关。膀胱疼痛所指的皮肤体对体壁组织的刺激也可能会增加敏感性。我们对膀胱对扩张的痛觉过敏的理解的进步以及这种皮肤刺激阈值的存在将有助于我们设计更优雅和循证的IC治疗方法。这项建议首先描述了一项简单的研究，通过填充IC受试者和对照组来测量膀胱感觉的感觉方面。其次，描述了使用神经计作为一种简单的仪器来测量皮肤对2000赫兹、250赫兹和5赫兹频率刺激的阈值。最后，测试疼痛和膀胱充盈感觉的时间总和，作为疼痛通路集中敏感化的一种测量方法。如果这种心理物理测试的结果在IC患者中被证明是显著改变的，简单的盆腔转诊皮肤病的临床测试可能允许临床医生评估患者的中枢敏感化，然后相应地设计和评估治疗方法。

DESCRIPTION (provided by applicant): Recent insights into the neurobiology of interstitial cystitis (IC) and into mechanisms of visceral pain suggest that, like other visceral pain syndromes, IC may be associated with hyperalgesia of the bladder itself, and central sensitization of pain pathways from the bladder. There also may be increased sensitivity to stimulation of body wall tissues in dermatomes to which bladder pain refers. Advances in our understanding of bladder hyperalgesia to distension and the presence of such altered cutaneous stimulation thresholds will help us to design more elegant and evidence-based treatments for IC. This proposal first describes a simple study to measure sensory aspects of bladder sensation with filling in subjects with IC and in controls. Secondly, the use of a Neurometer as a simple instrument to measure cutaneous thresholds to stimulation at frequencies of 2000Hz, 250 Hz, and 5 Hz is described. Finally, testing for the presence of temporal summation of pain and bladder filling sensations as a measure of centralized sensitization of pain pathways is described. If the results of this psychophysical testing prove to be significantly altered in subjects with IC, simple clinical testing of pelvic referral dermatomes may allow clinicians to assess patients for central sensitization, then design and evaluate treatments accordingly.