Role of CNS in Modulation of Pelvic Pain Syndrome

中枢神经系统在调节盆腔疼痛综合征中的作用

• 批准号: 7571839
• 负责人: ANTHONY J SCHAEFFER
• 金额: $ 29.07万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-15 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7571839
• 关键词: Acute; Acute Pain; Affect; Age; Analgesics; Anatomy; Atrophic; Back Pain; Biological Markers; Brain; Characteristics; Chronic; Chronic Prostatitis; Class; Clinical; Clinical Trials; Cognitive; Condition; Diffusion Magnetic Resonance Imaging; Disease; Economics; Emotional; Exhibits; Face; Foundations; Functional Magnetic Resonance Imaging; Gambling; Gastrointestinal Diseases; Gender; Health; Hypersensitivity skin testing; Impaired cognition; Impairment; Injury; Interstitial Cystitis; Iowa; Irritable Bowel Syndrome; Localized; Location; Magnetic Resonance Imaging; Measures; Mechanics; Medial; Morbidity - disease rate; Nerve Degeneration; Pain; Pain Disorder; Participant; Patients; Pattern; Pelvic Pain; Performance; Pharmacotherapy; Physiology; Prefrontal Cortex; Purpose; Quality of life; Reporting; Resolution; Response to stimulus physiology; Rodent; Role; Severities; Site; Skin; Specificity; Stimulus; Symptoms; Syndrome; Tactile; Testing; Time; Touch sensation; Visceral; Visceral pain; cerebral atrophy; chronic pain; chronic pelvic pain; cognitive function; morphometry; novel; painful bladder syndrome; painful neuropathy; response; social; spontaneous pain; urinary; urologic

As with many chronic pain disorders, Syndromes of Chronic Pelvic Pain (SCPP), which, for the purposes of this proposal, include Urological Syndromes of Chronic Pelvic Pain (UCPPS) [interstitial cystitis (1C), painful bladder syndrome (PBS), chronic prostatitis (CP), chronic pelvic pain syndrome (CPPS)] and a commonly comorbid gastroenterological pain syndrome, Irritable Bowel Syndrome (IBS)] are poorly understood and debilitating disorders for which treatment is mostly empirical and unsatisfactory. In preliminary studies, UCPPS patients exhibited brain atrophy and increased brain activity in the mPFC. These changes in UCPPS are similar-yet-distinct from those seen in Chronic Back Pain (CBP) and are different from acute pain. In addition, differential findings of UCPPS spontaneous pain fluctuations and brain activity, referred pain/hypersensitivity tests, and cognitive tests suggest that UCPPS pain presents a profile distinct from other chronic pain. Similar results have been reported in IBS. Thus, we hypothesize that UCPPS and IBS uniquely impact the brain and that brain markers correlate with clinical parameters of SCPP and are influenced by the location duration and severity of the pelvic pain. To test this hypothesis, we will pursue four aims by characterizing SCPP and age/gendermatched controls in each aim. In Aim 1, brain morphometry will be measured precisely. In Aim 2, local brain activity will be quantified in real time. In Aim 3, cognitive function deficits will be evaluated. And in Aim 4, skin sensitivity will be quantified to assess the specificity of referred pain. Thus, these studies will identify novel brain and cognitive biomarkers of SCPP. These studies will also provide the foundation for targeted pharmacotherapies tailored to SCPP. KEY ABBREVIATIONS SCPP = Syndromes of Chronic Pelvic Pain UCPPS = Urological Chronic Pelvic Pain Syndromes IBS = Irritable Bowel Syndrome CP = Chronic Prostatitis CPPS = Chronic Pelvic Pain Syndrome 1C = Interstitial Cystitis PBS = Painful Bladder Syndrome

与许多慢性疼痛疾病一样，慢性盆腔疼痛综合征 (SCPP) 该提案包括慢性盆腔疼痛泌尿系统综合征 (UCPPS) [间质性膀胱炎 (1C)、疼痛 膀胱综合征（PBS）、慢性前列腺炎（CP）、慢性盆腔疼痛综合征（CPPS）]以及常见的合并症 胃肠道疼痛综合征、肠易激综合征 (IBS)] 的了解甚少，并且 衰弱性疾病，其治疗大多是经验性的且不令人满意。 在初步研究中，UCPS 患者表现出脑萎缩，并且大脑活动增加 mPFC。 UCPPS 中的这些变化与慢性背痛 (CBP) 中的变化相似但又不同，并且 与急性疼痛不同。此外，UCPS 自发性疼痛波动和 大脑活动、牵涉疼痛/超敏反应测试和认知测试表明 UCPPS 疼痛表现为 与其他慢性疼痛不同的特征。 IBS 中也有类似的结果。 因此，我们假设 UCPPS 和 IBS 对大脑有独特的影响，并且大脑标记物 与 SCPP 的临床参数相关，并受位置持续时间和严重程度的影响 骨盆疼痛。为了检验这一假设，我们将通过描述 SCPP 和年龄/性别匹配来实现四个目标 控制每个目标。在目标 1 中，将精确测量大脑形态测量。在目标 2 中，本地 大脑活动将被实时量化。在目标 3 中，将评估认知功能缺陷。并且在 目标 4，皮肤敏感性将被量化，以评估牵涉疼痛的特异性。因此，这些研究将 识别 SCPP 的新型大脑和认知生物标志物。这些研究也将为 针对 SCPP 量身定制的靶向药物疗法。 主要缩写 SCPP = 慢性盆腔疼痛综合征 UCPPS = 泌尿科慢性盆腔疼痛综合征 IBS = 肠易激综合症 CP = 慢性前列腺炎 CPPS = 慢性盆腔疼痛综合症 1C = 间质性膀胱炎 PBS = 膀胱疼痛综合症