PURPOSE: The pathophysiology of interstitial cystitis/painful bladder syndrome (IC/PBS) remains incompletely understood, but is thought to involve a central disturbance in the processing of pain and viscerosensory signals.
We aimed to identify differences in brain activity and connectivity between female IC/PBS patients and healthy controls in order to advance clinical phenotyping and treatment efforts for IC/PBS.
MATERIALS AND METHODS: We examined oscillation dynamics of intrinsic brain activity in a large sample of well-phenotyped female IC/PBS patients and female healthy controls collected during a 10-minute resting fMRI scan as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network* project. The BOLD signal was transformed to the frequency domain and relative power was computed for multiple frequency bands.
RESULTS: The results demonstrated altered frequency distributions in viscerosensory (post insula), somatosensory (postcentral gyrus) and motor regions (anterior paracentral lobule, medial and ventral supplementary motor area (SMA)) in IC/PBS patients. Additionally, anterior paracentral lobule, medial SMA and ventral SMA all demonstrated increased functional connectivity to the midbrain (red nucleus) and cerebellum. This increased functional connectivity was greatest in patients reporting pain during bladder filling.
CONCLUSIONS: These findings suggest that women with IC/PBS have a sensorimotor component to their pathology involving an alteration in the intrinsic oscillations and connectivity within a cortico-cerebellar network previously associated with urinary bladder function.
Written by:
Kilpatrick LA, Kutch JJ, Tillisch K, Naliboff B, Labus J, Jiang Z, Farmer M, Apkarian AV, Mackey S, Martucci KT, Clauw D, Harris RE, Deutsch G, Ness T, Yang CC, Maravilla K, Mullins C, Mayer EA. Are you the author?
Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA; Human Performance and Engineering Laboratory, Kessler Foundation Research Center, West Orange, New Jersey, USA; Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey, USA; Department of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA; Department of Anesthesiology, Perioperative and Pain Medicine, Division of Pain Medicine, Stanford University Medical Center, Stanford, CA, USA; Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, USA; Departments of Radiology and Anesthesiology, University of Alabama, Birmingham Medical Center, USA; Department of Urology, University of Washington, Seattle, WA, USA; Department of Radiology, University of Washington, Seattle, WA, USA; National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA.
Reference: J Urol. 2014 Mar 25. pii: S0022-5347(14)03044-4.
doi: 10.1016/j.juro.2014.03.093
PubMed Abstract
PMID: 24681331
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