Mechanistic Distinctions in Female Chronic Pelvic Pain Subtypes

女性慢性盆腔疼痛亚型的机制差异

• 批准号: 8738696
• 负责人: Colleen Marie Fitzgerald
• 金额: $ 12.42万
• 依托单位: LOYOLA UNIVERSITY CHICAGO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-23 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8738696
• 关键词: Accounting; Automobile Driving; Biological Markers; Brain; Brain imaging; Characteristics; Chronic; Classification; Clinical; Comorbidity; Complex; Cutaneous; Diabetes Mellitus; Diagnosis; Dissection; Electromyography; Elements; Etiology; Female; Functional Magnetic Resonance Imaging; Goals; Health; Health Services; Heart Diseases; Interstitial Cystitis; Intervention; Investigation; Joints; Knowledge; Malignant Neoplasms; Mechanics; Methods; Muscle; Musculoskeletal; Musculoskeletal Pain; Nociception; Outcome Study; Pain; Pain Disorder; Pain-Free; Pattern; Pelvic Girdle; Pelvic Pain; Pelvic floor structure; Pelvis; Peripheral; Population; Postpartum Period; Pregnancy; Property; Psychophysics; Public Health; Quality of life; Sensory; Severities; Shapes; Site; Symptoms; System; Testing; Tissues; United States; Variant; Visceral; Visceral pain; Vulvodynia; Woman; Work; bladder pain; central pain; chronic pain; chronic pelvic pain; cost; endometriosis; improved; patient population; pressure; public health relevance; relating to nervous system; transmission process

DESCRIPTION (provided by applicant): Chronic pain is a significant and highly prevalent health condition and women comprise a majority of all chronic pain populations, particularly persistent pelvic pain. Female chronic pelvic pain (CPP) is a rapidly growing and costly health concern, and may reflect a number of underlying pain diagnoses including endometriosis, interstitial cystitis, vulvodynia and pregnancy-related pelvic pain. The frequent comorbidities shared by these pain conditions have been attributed to the complex interplay of somatic (cutaneous and musculoskeletal), visceral, and viscero-visceral crosstalk that shapes peripheral pain transmission within the pelvic girdle. Unfortunately, many previous attempts to understand normal and pathological variants of pelvic pain have primarily focused on these types of pain in isolation rather than considering system interactions. Our long term goal is to delineate the differences between pelvic pain mechanisms critical to the understanding, classification, and treatment of these myriad pain conditions. An examination of subtypes that are predominated by prototypical somatic features compared to visceral features will be undertaken. The short term goal of this application is to examine the sensory and functional characteristics of women with postpartum pelvic pain (somatic-musculoskeletal pain) and interstitial cystitis/IC/CPP (visceral pain), compared with women without CPP. Additionally, we will initiate preliminary investigation in the central brain imaging of these CPP subtypes. Our central hypothesis is that women with varying types of CPP will demonstrate unique peripheral (sensory and functional) and central characteristics specific to their diagnoses and their underlying mechanisms. The expected outcome of this study is the delineation of the clinical and scientific assessment methods that most accurately reflect the underlying peripheral and possible central mechanisms driving CPP subtypes. The public health impact of this proposed work will be to enable clinicians to provide more timely and targeted interventions to improve the quality of life of women with CPP.

描述(申请人提供)：慢性疼痛是一种重要的和高度流行的健康状况，女性占所有慢性疼痛人群的大多数，特别是持续性盆腔疼痛。女性慢性盆腔疼痛(CPP)是一种迅速增长且代价高昂的健康问题，可能反映了许多潜在的疼痛诊断，包括子宫内膜异位症、间质性膀胱炎、外阴疼痛和与妊娠相关的盆腔疼痛。由于躯体(皮肤和肌肉骨骼)、内脏和内脏-内脏的串扰形成了盆腔腰带内的外周疼痛传递，这些疼痛状况共同的常见并发症被归因于复杂的相互作用。不幸的是，许多以前试图了解盆腔疼痛的正常和病理变体的尝试主要集中在这些类型的孤立的疼痛上，而不是考虑系统的相互作用。我们的长期目标是描述盆腔疼痛机制之间的差异，这对了解、分类和治疗这些无数的疼痛状况至关重要。将对以典型躯体特征为主的亚型与内脏特征进行比较。该应用的短期目标是检查患有产后盆腔疼痛(躯体-肌肉骨骼疼痛)和间质性膀胱炎/IC/CPP(内脏疼痛)的妇女的感觉和功能特征，并与没有CPP的妇女进行比较。此外，我们将启动对这些CPP亚型的中枢脑成像的初步研究。我们的中心假设是，患有不同类型CPP的女性将表现出独特的外周(感觉和功能)和中枢特征，这些特征特定于她们的诊断和潜在的机制。这项研究的预期结果是勾勒出最准确地反映驱动CPP亚型的潜在的外周和可能的中枢机制的临床和科学评估方法。这项拟议工作的公共卫生影响将使临床医生能够提供更及时和更有针对性的干预措施，以改善患有慢性阻塞性肺病的妇女的生活质量。