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Brain White Matter Abnormalities in Female Interstitial Cystitis/Bladder Pain Syndrome: A MAPP Network Neuroimaging Study

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By M. A. Farmer et al.
 
Abstract

Purpose: Several chronic pain conditions may be distinguished by condition-specific brain anatomical and functional abnormalities observed by imaging suggestive of underlying disease processes. Here we present the first characterization of IC/BPS-associated white matter (axonal) abnormalities based on multi-center neuroimaging from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network.
 
Materials and Methods: Women with IC/BPS (n=34) and healthy controls (n=32) were assessed with questionnaires on pain, mood, and daily function. White matter microstructure was evaluated with diffusion tensor imaging (DTI) to model directional water flow along axons, or fractional anisotropy (FA). Regions that correlated with clinical parameters were further examined for sex and syndrome dependence.
 
Results: Women with IC/BPS exhibited numerous white matter abnormalities that correlated with severity of pain, urinary symptoms, and impaired quality of life. IC/BPS was characterized by decreased FA in aspects of the right anterior thalamic radiation, left forceps major, and right longitudinal fasciculus. Increased FA was detected in the right superior and bilateral inferior longitudinal fasciculi.
 
Conclusions: The first characterization of brain white matter abnormalities in women with IC/BPS reveals that regional decreases and increases in white matter integrity, across multiple axonal tracts, are associated with symptom severity in IC/BPS. Given that white matter abnormalities closely correlate with hallmark symptoms of IC/BPS, including bladder pain and urinary symptoms, brain anatomical alterations suggest neuropathological contributions to chronic urological pelvic pain.
 
Source: Farmer MA, Huang L, Martucci K, Yang CC, Maravilla KR, Harris RE, Clauw DJ, Mackey S, Ellingson BM, Mayer EA, Schaeffer AJ, Apkarian AV; MAPP Research Network. Brain White Matter Abnormalities in Female Interstitial Cystitis/Bladder Pain Syndrome: A MAPP Network Neuroimaging Study. J Urol. 2015 Jul;194(1):118-26. doi: 10.1016/j.juro.2015.02.082. Epub 2015 Feb 21.

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