CLINICAL PHENOTYPING FOR PAIN MECHANISMS IN UROLOGIC CHRONIC PELVIC PAIN SYNDROMES: A MAPP RESEARCH NETWORK STUDY

Andrew Schrepf; Robert Gallop; Bruce Naliboff; Steven E. Harte; Niloofar Afari; H. Henry Lai; Michel Pontari; Lindsey C. McKernan; Eric Strachan; Karl J. Kreder; Sawsan A. As-Sanie; Larissa V. Rodriguez; James W. Griffith; David A. Williams; Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network

doi:10.1016/j.jpain.2022.03.240

Back

CLINICAL PHENOTYPING FOR PAIN MECHANISMS IN UROLOGIC CHRONIC PELVIC PAIN SYNDROMES: A MAPP RESEARCH NETWORK STUDY

Journal article

Open access

Peer reviewed

CLINICAL PHENOTYPING FOR PAIN MECHANISMS IN UROLOGIC CHRONIC PELVIC PAIN SYNDROMES: A MAPP RESEARCH NETWORK STUDY

Andrew Schrepf, Robert Gallop, Bruce Naliboff, Steven E. Harte, Niloofar Afari, H. Henry Lai, Michel Pontari, Lindsey C. McKernan, Eric Strachan, Karl J. Kreder, …

The journal of pain, Vol.23(9), pp.1594-1603

09/01/2022

DOI: 10.1016/j.jpain.2022.03.240

PMCID: PMC10547025

PMID: 35472518

Files and links (1)

url

https://doi.org/10.1016/j.jpain.2022.03.240View

Published (Version of record) Open Access

Abstract

•Three recognized pain mechanisms are present in Urologic Pelvic Pain Syndrome•Different patterns of clinical presentation and treatment utilization are apparent Perspective: This article presents differences in clinical characteristics based on a simple self-report method of classifying pain mechanisms for Urologic Chronic Pelvic Pain Syndrome patients. This method can be easily applied to other chronic pain conditions and may be useful for exploring pathophysiology in pain subtypes. Disclosures: Funding for the MAPP Research Network was obtained under a cooperative agreement from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH) [DK082315 (Andriole, G; Lai, H), DK082316 (Landis, J), DK082325 (Buchwald, D), DK082333 (Lucia, M), DK082342 (Klumpp, D; Schaeffer A), DK082344 (Kreder, K), DK082345 (Clauw, D; Clemens, JQ), DK082370 (Mayer, E; Rodriguez L), DK103227 (Moses, M), DK103260 (Anger, J; Freeman, M), DK103271 (Nickel, J)]. Three categories of pain mechanisms are recognized as contributing to pain perception: nociceptive, neuropathic, and nociplastic (i.e., central nervous system augmented pain processing). We use validated questionnaires to identify pain mechanisms in Urologic Chronic Pelvic Pain Syndrome (UCCPS) patients (n=568, female=378, male= 190) taking part in the Symptom Patterns Study of the Multidisciplinary Approach to the study of chronic Pelvic Pain Research Network. A cutoff score of 12 on the painDETECT questionnaire (-1-38) was used to classify patients into the neuropathic category while the median score of 7 on the fibromyalgia survey criteria (0-31) was used to classify patients into the nociplastic category. Categories were compared on demographic, clinical, psychosocial, psychophysical and medication variables. At baseline, 43% of UCPPS patients were classified as nociceptive-only, 8% as neuropathic only, 27% as nociceptive+nociplastic, and 22% as neuropathic+nociplastic. Across outcomes nociceptive-only patients had the least severe symptoms and neuropathic+nociplastic patients the most severe. Neuropathic pain was associated with genital pain/sensitivity on pelvic exam, while nociplastic pain was associated with comorbid pain conditions, psychosocial difficulties, and increased pressure pain sensitivity outside the pelvis. A self-report method classifying individuals on pain mechanisms reveals clinical differences that could inform clinical trials and novel targets for treatment.

central nervous system sensitization

chronic pain

cystitis, interstitial

neuropathic pain

nociceptive pain

prostatitis

Details

Title: Subtitle: CLINICAL PHENOTYPING FOR PAIN MECHANISMS IN UROLOGIC CHRONIC PELVIC PAIN SYNDROMES: A MAPP RESEARCH NETWORK STUDY
Creators: Andrew Schrepf - University of Michigan
Robert Gallop - University of Pennsylvania
Bruce Naliboff - University of California, Los Angeles
Steven E. Harte - University of Michigan
Niloofar Afari - University of California San Diego
H. Henry Lai - Washington University in St. Louis
Michel Pontari - Temple University
Lindsey C. McKernan - Vanderbilt University Medical Center
Eric Strachan - University of Washington
Karl J. Kreder - University of Iowa
Sawsan A. As-Sanie - University of Michigan
Larissa V. Rodriguez - University of Southern California
James W. Griffith - Northwestern University
David A. Williams - University of Michigan
Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network
Resource Type: Journal article
Publication Details: The journal of pain, Vol.23(9), pp.1594-1603
DOI: 10.1016/j.jpain.2022.03.240
PMID: 35472518
PMCID: PMC10547025
NLM abbreviation: J Pain
ISSN: 1526-5900
eISSN: 1528-8447
Publisher: Elsevier Inc
Grant note: DOI: 10.13039/100000002, name: National Institutes of Health, award: DK082315, DK082316, DK082325, DK082333, DK082342, DK082344, DK082345, DK082370, DK103227, DK103260, DK103271; DOI: 10.13039/100000062, name: National Institute of Diabetes and Digestive and Kidney Diseases
Language: English
Date published: 09/01/2022
Academic Unit: Obstetrics and Gynecology; Urology
Record Identifier: 9984383905302771

Metrics

10 Record Views

12 Times Cited - Web of Science

See more details