Mechanistic Distinctions in Female Chronic Pelvic Pain Subtypes

描述（由申请人提供）：慢性疼痛是一种重要且高度普遍的健康状况，女性占所有慢性疼痛人群的大多数，尤其是持续性盆腔疼痛。女性慢性盆腔疼痛（CPP）是一个快速增长和昂贵的健康问题，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、外阴痛和妊娠相关的盆腔疼痛。这些疼痛条件的常见合并症归因于躯体（皮肤和肌肉骨骼）、内脏和内脏-内脏相互作用的复杂相互作用，这些相互作用形成了骨盆带内外周疼痛的传递。不幸的是，许多先前试图了解骨盆疼痛的正常和病理变异主要集中在这些类型的疼痛孤立，而不是考虑系统的相互作用。我们的长期目标是描述骨盆疼痛机制之间的差异，这对理解、分类和治疗这些无数的疼痛状况至关重要。与内脏特征相比，以原型躯体特征为主的亚型将进行检查。本应用程序的短期目标是检查产后盆腔疼痛（躯体-肌肉-骨骼疼痛）和间质性膀胱炎/IC/CPP（内脏疼痛）妇女的感觉和功能特征，与没有CPP的妇女进行比较。此外，我们将对这些CPP亚型的中央脑成像进行初步研究。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围（感觉和功能）和中心特征，具体到她们的诊断和潜在机制。本研究的预期结果是描述临床和科学评估方法，最准确地反映驱动CPP亚型的潜在外周和可能的中枢机制。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有针对性的干预措施，以改善CPP妇女的生活质量。

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.