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Unique Microstructural Changes in the Brain Associated with Urological Chronic Pelvic Pain Syndrome (UCPPS) Revealed
Davis Woodworth1, Emeran Mayer2, Kevin Leu3
1Department of Radiological Science, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America; Department of Biomedical Physics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America; Oppenheimer Center for the Neurobiology of Stress, and PAIN, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, United States of America.
Urological chronic pelvic pain syndrome (UCPPS) involves brain microstructural differences, particularly in pain processing regions, distinguishing it from irritable bowel syndrome (IBS). These brain changes appear linked to chronic pain duration.
Area of Science:
- Neuroscience
- Medical Imaging
- Pain Research
Background:
- Chronic pain syndromes are linked to neural reorganization.
- Urological chronic pelvic pain syndrome (UCPPS) encompasses poorly understood conditions like Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) and Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS).
- Effective treatments for UCPPS remain limited due to unclear pathophysiology.
Purpose of the Study:
- To investigate microstructural brain differences in UCPPS patients.
- To compare brain structure between UCPPS, irritable bowel syndrome (IBS), and healthy controls (HCs).
- To identify brain alterations specific to UCPPS.
Main Methods:
- Population-based voxel-wise diffusion tensor imaging (DTI) and super-resolution track density imaging (TDI).
- Analysis of a large, two-center sample including UCPPS (N=45), IBS (N=39), and HCs (N=56).
- Correlation analysis between brain imaging metrics and symptom scores.
Main Results:
- UCPPS patients exhibited lower fractional anisotropy (FA), generalized anisotropy (GA), track density, and higher mean diffusivity (MD) compared to HCs in pain-related brain regions.
- Significant microstructural differences were found in UCPPS patients compared to IBS patients, suggesting UCPPS-specific alterations.
- Brain alterations in UCPPS were localized to the pain integration, modulation, and perception pathways, correlating with symptom severity.
Conclusions:
- UCPPS is associated with extensive, syndrome-specific microstructural brain differences.
- These brain alterations are concentrated in regions involved in sensory information processing and pain modulation.
- The observed brain changes in UCPPS appear to be a consequence of long-standing pain.
