Journal article
Neurobiology and long-term impact of bladder-filling pain in humans: a Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) research network study
Pain (Amsterdam), Vol.164(10), pp.2343-2351
10/2023
DOI: 10.1097/j.pain.0000000000002944
PMCID: PMC10524087
PMID: 37278657
Abstract
Supplemental Digital Content is Available in the Text.Painful bladder filling assessed experimentally is associated with brain alterations, greater disease burden, and worse long-term outcomes in urologic chronic pelvic pain syndrome.
AbstractPain with bladder filling remains an unexplained clinical presentation with limited treatment options. Here, we aim to establish the clinical significance of bladder filling pain using a standardized test and the associated neural signature. We studied individuals diagnosed with urologic chronic pelvic pain syndrome (UCPPS) recruited as part of the multidisciplinary approach to the study of chronic pelvic pain (MAPP) study. Patients with urologic chronic pelvic pain syndrome (N = 429) and pain-free controls (N = 72) underwent a test in which they consumed 350 mL of water and then reported pain across an hour-long period at baseline and 6 months. We used latent class trajectory models of these pain ratings to define UCPPS subtypes at both baseline and 6 months. Magnetic resonance imaging of the brain postconsumption was used to examine neurobiologic differences between the subtypes. Healthcare utilization and symptom flare-ups were assessed over the following 18 months. Two distinct UCPPS subtypes were identified, one showing substantial pain related to bladder filling and another with little to no pain throughout the test. These distinct subtypes were seen at both baseline and 6 month timepoints. The UCPPS subtype with bladder-filling pain (BFP+) had altered morphology and increased functional activity in brain areas involved in sensory and pain processing. Bladder-filling pain positive status predicted increased symptom flare-ups and healthcare utilization over the subsequent 18 months when controlling for symptom severity and a self-reported history of bladder-filling pain. These results both highlight the importance of assessing bladder filling pain in heterogeneous populations and demonstrate that persistent bladder-filling pain profoundly affects the brain.
Details
- Title: Subtitle
- Neurobiology and long-term impact of bladder-filling pain in humans: a Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) research network study
- Creators
- Andrew D. Schrepf - University of Michigan Medical SchoolIshtiaq Mawla - University of Michigan Medical SchoolBruce D. Naliboff - University of California, Los AngelesBob Gallop - University of PennsylvaniaRobert M. Moldwin - Zucker School of Medicine at Hofstra-Northwell, Lake Success, NYFrank Tu - University of ChicagoPriyanka Gupta - University of MichiganSteven Harte - University of Michigan Medical SchoolJohn N. Krieger - University of Washington School of MedicineClaire Yang - University of Washington School of MedicineCatherine Bradley - Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IALarissa Rodriguez - Cornell UniversityDavid Williams - University of Michigan Medical SchoolVincent Magnotta - Department of Radiology, University of Iowa, Iowa City, IAEric Ichesco - University of Michigan Medical SchoolRichard E. Harris - University of Michigan Medical SchoolQuentin Clemens - University of MichiganChris Mullins - National Institute of Diabetes and Digestive and Kidney DiseasesJason J. Kutch - Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA
- Resource Type
- Journal article
- Publication Details
- Pain (Amsterdam), Vol.164(10), pp.2343-2351
- DOI
- 10.1097/j.pain.0000000000002944
- PMID
- 37278657
- PMCID
- PMC10524087
- NLM abbreviation
- Pain
- ISSN
- 0304-3959
- eISSN
- 1872-6623
- Publisher
- Wolters Kluwer
- Grant note
- This work was supported by a cooperative agreement from the National Institute of Health, National Institute of Diabetes and Digestive and Kidney Diseases (Grant numbers DK082370, DK082342, DK082315, DK082344, DK082325, DK082345, and DK082316), as well as: DK082370, DK082342, DK082315, DK082344, DK082325, DK082345, DK082316, DK110669, DK121724, DK123164 National Institute of Health, National Institute of Diabetes and Digestive and Kidney DiseasesNational Institute of Diabetes and Digestive and Kidney Diseases: U01DK082370, R01DK123164, U01DK082345
This work was supported by a cooperative agreement from the National Institute of Health, National Institute of Diabetes and Digestive and Kidney Diseases (Grant numbers DK082370, DK082342, DK082315, DK082344, DK082325, DK082345, and DK082316), as well as DK110669, DK121724, and DK123164. The authors thank all of the volunteers who participated in the study.
- Language
- English
- Date published
- 10/2023
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Psychiatry; Epidemiology; Iowa Neuroscience Institute; Obstetrics and Gynecology; Urology
- Record Identifier
- 9984811216302771
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