Sensory Testing in Subjects with Interstitial Cystitis

描述（由申请人提供）：最近对间质性膀胱炎（IC）的神经生物学和内脏疼痛机制的研究表明，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化有关。也可能是对膀胱疼痛所涉及的皮肤组织的体壁组织刺激的敏感性增加。我们对膀胱痛觉过敏引起的肿胀和这种改变的皮肤刺激阈值的理解的进展将帮助我们设计出更优雅和基于证据的IC治疗方法。本提案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在2000Hz， 250hz和5hz频率下的刺激阈值。最后，测试疼痛和膀胱充盈感觉的时间总和的存在，作为疼痛途径的集中敏感化的措施被描述。如果这种心理物理测试的结果在IC患者中被证明有显著改变，那么盆腔转诊皮组的简单临床测试可以让临床医生评估患者的中枢致敏，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.