Role of CNS in Modulation of Pelvic Pain Syndrome

与许多慢性疼痛障碍一样，慢性盆腔疼痛综合征(SCPP)，为了 这项建议，包括慢性盆腔疼痛的泌尿系统综合征(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)]以及一种常见的共病 胃肠痛综合征，肠易激综合征(IBS)]了解很少， 治疗大多是经验性的和不令人满意的衰弱障碍。 在初步研究中，UCPPS患者表现出脑萎缩和脑活动增加 MPFC。UCPPS的这些变化与慢性背痛(CBP)相似但又不同，并 不同于急性疼痛。此外，UCPPS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疼痛呈现出 不同于其他慢性疼痛的特征。类似的结果在IBS中也有报道。 因此，我们假设UCPPS和IBS对大脑和脑标志物有独特的影响 与SCPP的临床参数相关，并受病变部位、持续时间和严重程度的影响 骨盆疼痛。为了验证这一假设，我们将通过描述SCPP和年龄/性别匹配来实现四个目标 在每个目标中进行控制。在目标1中，将精确测量大脑形态测量。在Aim 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。在.中 目的将皮肤敏感度量化，以评估牵涉痛的特异性。因此，这些研究将 确定SCPP的新的脑和认知生物标记物。这些研究还将为以下工作奠定基础 针对SCPP量身定做的靶向药物疗法。 关键缩略语 慢性盆腔疼痛综合征 UCPPS=泌尿系统慢性盆腔疼痛综合征 IBS=肠易激综合征 CP=慢性前列腺炎 CPPS=慢性盆腔疼痛综合征 1C=间质性膀胱炎 PBS=痛性膀胱综合征

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