间质性膀胱炎/膀胱疼痛综合征女性感觉和运动网络静息状态振荡和连接的改变。
Alterations in resting state oscillations and connectivity in sensory and motor networks in women with interstitial cystitis/painful bladder syndrome.
机构信息
Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, David Geffen School of Medicine, University of California-Los Angeles (LAK, KT, BDN, JSL, ZJ, EAM), Los Angeles, California; Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles (JJK), California; Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center (SM, KTM), Stanford, California; Human Performance and Engineering Laboratory, Kessler Foundation Research Center, West Orange and Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey (ZJ); Department of Physiology, Feinberg School of Medicine, Northwestern University (MAF, AVA), Chicago, Illinois; Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan (DJC, REH), Ann Arbor, Michigan; Departments of Radiology and Anesthesiology, University of Alabama, Birmingham Medical Center (GD, TJN), Birmingham, Alabama; Department of Urology (CCY), University of Washington, Seattle, Washington; Department of Radiology (KTM), University of Washington, Seattle, Washington; National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health (CM), Bethesda, Maryland.
Gail and Gerald Oppenheimer Family Center for Neurobiology of Stress, David Geffen School of Medicine, University of California-Los Angeles (LAK, KT, BDN, JSL, ZJ, EAM), Los Angeles, California; Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles (JJK), California; Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center (SM, KTM), Stanford, California; Human Performance and Engineering Laboratory, Kessler Foundation Research Center, West Orange and Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, New Jersey (ZJ); Department of Physiology, Feinberg School of Medicine, Northwestern University (MAF, AVA), Chicago, Illinois; Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan (DJC, REH), Ann Arbor, Michigan; Departments of Radiology and Anesthesiology, University of Alabama, Birmingham Medical Center (GD, TJN), Birmingham, Alabama; Department of Urology (CCY), University of Washington, Seattle, Washington; Department of Radiology (KTM), University of Washington, Seattle, Washington; National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health (CM), Bethesda, Maryland.
出版信息
J Urol. 2014 Sep;192(3):947-55. doi: 10.1016/j.juro.2014.03.093. Epub 2014 Mar 26.
PURPOSE
The pathophysiology of interstitial cystitis/painful bladder syndrome remains incompletely understood but is thought to involve central disturbance in the processing of pain and viscerosensory signals. We identified differences in brain activity and connectivity between female patients with interstitial cystitis/painful bladder syndrome and healthy controls to advance clinical phenotyping and treatment efforts for interstitial cystitis/painful bladder syndrome.
MATERIALS AND METHODS
We examined oscillation dynamics of intrinsic brain activity in a large sample of well phenotyped female patients with interstitial cystitis/painful bladder syndrome and female healthy controls. Data were collected during 10-minute resting functional magnetic resonance imaging as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network project. The blood oxygen level dependent signal was transformed to the frequency domain. Relative power was calculated for multiple frequency bands.
RESULTS
Results demonstrated altered frequency distributions in viscerosensory (post insula), somatosensory (postcentral gyrus) and motor regions (anterior paracentral lobule, and medial and ventral supplementary motor areas) in patients with interstitial cystitis/painful bladder syndrome. Also, the anterior paracentral lobule, and medial and ventral supplementary motor areas showed increased functional connectivity to the midbrain (red nucleus) and cerebellum. This increased functional connectivity was greatest in patients who reported pain during bladder filling.
CONCLUSIONS
Findings suggest that women with interstitial cystitis/painful bladder syndrome have a sensorimotor component to the pathological condition involving an alteration in intrinsic oscillations and connectivity in a cortico-cerebellar network previously associated with bladder function.
目的
间质性膀胱炎/膀胱疼痛综合征的病理生理学仍不完全清楚，但据认为涉及疼痛和内脏感觉信号处理的中枢紊乱。我们确定了间质性膀胱炎/膀胱疼痛综合征女性患者与健康对照之间大脑活动和连通性的差异，以推进间质性膀胱炎/膀胱疼痛综合征的临床表型和治疗工作。
材料和方法
我们检查了大量经过良好表型分析的间质性膀胱炎/膀胱疼痛综合征女性患者和女性健康对照的内在大脑活动的振荡动力学。数据是作为多学科慢性盆腔疼痛研究网络项目的一部分，在 10 分钟的静息功能磁共振成像期间收集的。血氧水平依赖信号被转换到频域。为多个频带计算相对功率。
结果
结果表明，间质性膀胱炎/膀胱疼痛综合征患者的内脏感觉（后岛叶）、躯体感觉（后中央回）和运动区域（前中央旁小叶、内侧和腹侧辅助运动区）的频率分布发生改变。此外，前中央旁小叶、内侧和腹侧辅助运动区与中脑（红核）和小脑的功能连接增加。在报告膀胱充盈时疼痛的患者中，这种功能连接增加最大。
结论
研究结果表明，间质性膀胱炎/膀胱疼痛综合征女性患者存在涉及内在振荡和以前与膀胱功能相关的皮质-小脑网络连通性改变的病理状况的感觉运动成分。
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