Central Nervous System the key?

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webslave
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Central Nervous System the key?

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J Urol. 2011 Jul;186(1):117-24. Epub 2011 May 14.
Brain functional and anatomical changes in chronic prostatitis/chronic pelvic pain syndrome.

Farmer MA, Chanda ML, Parks EL, Baliki MN, Apkarian AV, Schaeffer AJ.
Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.


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.

PMID: 21571326
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BrenN
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Re: Central Nervous System the key?

Post by BrenN »

I don't suppose you can break this down into laymens terms
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Re: Central Nervous System the key?

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Pelvic pain shows up differently in the brain compared to other pain, and seems to affect the brain differently. It suggests that the brain may be a player in starting and maintaining the pain. More research is needed!
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BrenN
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Re: Central Nervous System the key?

Post by BrenN »

Makes sense to me. Testicular tingling is my worst and most common symptom. Thinking of something that makes me anxious or nervous actually triggers the tingling. This occurs even when very relaxed so it doesn't always have to do with me tensing my pelvic muscles. For me this symptom is definitely connected to my nervous system in a very obvious way
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Re: Central Nervous System the key?

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Comment on this study in European Urology that I missed:
Nevertheless, there is some light at the end of the tunnel: recent neuro-imaging studies found cerebral correlates for CPPS! Pelvic pain was uniquely characterised by functional activation in the right anterior insula, which correlated with clinical pain intensity. Relative grey matter volume reduction in the anterior cingulate cortex and correlation with bother of CPPS suggested an essential role of the anterior cingulate cortex in CPPS. Functional connectivity between the motor cortex and the posterior insula may be among the most important markers of altered brain function in CPPS, and may represent changes in the integration of viscero-sensory and motor processing. Moreover, in patients with CPPS, regions of the posterior medial cortex seem detached from the default mode network, whereas neurological processes of self-referential thought and introspection may be joined to pain and emotion regulatory processes. Thus, a more profound understanding of the mechanisms involved in initiating and maintaining CPPS is essential and cerebral correlates may become promising novel therapeutic targets
http://www.europeanurology.com/article/ ... 7/fulltext
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