Brain Functional and Anatomical Changes in Chronic Prostatitis/Chronic Pelvic Pain Syndrome (2011)

No AccessJournal of UrologyAdult Urology1 Jul 2011Brain Functional and Anatomical Changes in Chronic Prostatitis/Chronic Pelvic Pain Syndrome Melissa A. Farmer, Mona L. Chanda, Elle L. Parks, Marwan N. Baliki, A. Vania Apkarian, and Anthony J. Schaeffer Melissa A. FarmerMelissa A. Farmer Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois More articles by this author , Mona L. ChandaMona L. Chanda Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois More articles by this author , Elle L. ParksElle L. Parks Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois More articles by this author , Marwan N. BalikiMarwan N. Baliki Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois More articles by this author , A. Vania ApkarianA. Vania Apkarian Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Department of Anesthesia, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Recipient of National Institutes of Health National Institute of Neurological Disorders and Stroke Grant R01 NS35115. More articles by this author , and Anthony J. SchaefferAnthony J. Schaeffer Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Recipient of National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases Grant U01 DK65277. Financial interest and/or other relationship with the American Urological Association/The Journal of Urology®, Advanstar Communications, UpToDate Inc., Flashpoint Medica, BMJ Group, SPD Development Company and Hagen/Sinclair Research Recruiting Inc. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.03.027AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Research into the pathophysiology of chronic prostatitis/chronic pelvic pain syndrome has primarily focused on markers of peripheral dysfunction. We present the first neuroimaging investigation to our knowledge to characterize brain function and anatomy in chronic prostatitis/chronic pelvic pain syndrome. Materials and Methods: We collected data from 19 male patients with chronic prostatitis/chronic pelvic pain syndrome, and 16 healthy age and gender matched controls. Functional magnetic resonance imaging data were obtained from 14 patients with chronic prostatitis/chronic pelvic pain syndrome as they rated spontaneous pain inside the scanner. Group differences (16 patients per group) in gray matter total volume and regional density were evaluated using voxel-based morphometry, and white matter integrity was studied with diffusion tensor imaging to measure fractional anisotropy. Functional and anatomical imaging outcomes were correlated with the clinical characteristics of chronic prostatitis/chronic pelvic pain syndrome. Results: Spontaneous pelvic pain was uniquely characterized by functional activation within the right anterior insula, which correlated with clinical pain intensity. No group differences were found in regional gray matter volume, yet density of gray matter in pain relevant regions (anterior insula and anterior cingulate cortices) positively correlated with pain intensity and extent of pain chronicity. Moreover the correlation between white matter anisotropy and neocortical gray matter volume was disrupted in chronic prostatitis/chronic pelvic pain syndrome. Conclusions: We provide novel evidence that the pain of chronic prostatitis/chronic pelvic pain syndrome is associated with a chronic pelvic pain syndrome specific pattern of functional brain activation and brain anatomical reorganization. These findings necessitate further investigations into the role of central mechanisms in the initiation and maintenance of chronic prostatitis/chronic pelvic pain syndrome. References 1 : Validation of a modified National Institutes of Health chronic prostatitis symptom index to assess genitourinary pain in both men and women. Urology2009; 74: 983. Google Scholar 2 : Alfuzosin and symptoms of chronic prostatitis-chronic pelvic pain syndrome. N Engl J Med2008; 359: 2663. Google Scholar 3 : Textbook of Pain. In: . London: Churchill Livingston1999: 1125. Google Scholar 4 : Human brain mechanisms of pain perception and regulation in health and disease. Eur J Pain2005; 9: 463. Google Scholar 5 : Towards a theory of chronic pain. 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Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byKleinhans N, Yang C, Strachan E, Buchwald D and Maravilla K (2018) Alterations in Connectivity on Functional Magnetic Resonance Imaging with Provocation of Lower Urinary Tract Symptoms: A MAPP Research Network Feasibility Study of Urological Chronic Pelvic Pain SyndromesJournal of Urology, VOL. 195, NO. 3, (639-645), Online publication date: 1-Mar-2016.Sadler K and Kolber B (2018) Urine Trouble: Alterations in Brain Function Associated with Bladder PainJournal of Urology, VOL. 196, NO. 1, (24-32), Online publication date: 1-Jul-2016.Kairys A, Schmidt-Wilcke T, Puiu T, Ichesco E, Labus J, Martucci K, Farmer M, Ness T, Deutsch G, Mayer E, Mackey S, Apkarian A, Maravilla K, Clauw D and Harris R (2018) Increased Brain Gray Matter in the Primary Somatosensory Cortex is Associated with Increased Pain and Mood Disturbance in Patients with Interstitial Cystitis/Painful Bladder SyndromeJournal of Urology, VOL. 193, NO. 1, (131-137), Online publication date: 1-Jan-2015.Farmer M, Huang L, Martucci K, Yang C, Maravilla K, Harris R, Clauw D, Mackey S, Ellingson B, Mayer E, Schaeffer A and Apkarian A (2018) Brain White Matter Abnormalities in Female Interstitial Cystitis/Bladder Pain Syndrome: A MAPP Network Neuroimaging StudyJournal of Urology, VOL. 194, NO. 1, (118-126), Online publication date: 1-Jul-2015.Kilpatrick L, Kutch J, Tillisch K, Naliboff B, Labus J, Jiang Z, Farmer M, Apkarian A, Mackey S, Martucci K, Clauw D, Harris R, Deutsch G, Ness T, Yang C, Maravilla K, Mullins C and Mayer E (2018) Alterations in Resting State Oscillations and Connectivity in Sensory and Motor Networks in Women with Interstitial Cystitis/Painful Bladder SyndromeJournal of Urology, VOL. 192, NO. 3, (947-955), Online publication date: 1-Sep-2014.Samplaski M, Li J and Shoskes D (2018) Clustering of UPOINT Domains and Subdomains in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome and Contribution to Symptom SeverityJournal of Urology, VOL. 188, NO. 5, (1788-1793), Online publication date: 1-Nov-2012.Mordasini L, Weisstanner C, Rummel C, Thalmann G, Verma R, Wiest R and Kessler T (2018) Chronic Pelvic Pain Syndrome in Men is Associated with Reduction of Relative Gray Matter Volume in the Anterior Cingulate Cortex Compared to Healthy ControlsJournal of Urology, VOL. 188, NO. 6, (2233-2237), Online publication date: 1-Dec-2012. Volume 186Issue 1July 2011Page: 117-124 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsimage cytometrydiffusion tensor imagingcerebral cortexmagnetic resonance imagingMetricsAuthor Information Melissa A. Farmer Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois More articles by this author Mona L. Chanda Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois More articles by this author Elle L. Parks Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois More articles by this author Marwan N. Baliki Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois More articles by this author A. Vania Apkarian Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Department of Anesthesia, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Recipient of National Institutes of Health National Institute of Neurological Disorders and Stroke Grant R01 NS35115. More articles by this author Anthony J. Schaeffer Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois Recipient of National Institutes of Health National Institute of Diabetes and Digestive and Kidney Diseases Grant U01 DK65277. Financial interest and/or other relationship with the American Urological Association/The Journal of Urology®, Advanstar Communications, UpToDate Inc., Flashpoint Medica, BMJ Group, SPD Development Company and Hagen/Sinclair Research Recruiting Inc. 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