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Autonomic neurophysiologic implications of disorders comorbid with bladder pain syndrome vs myofascial pelvic pain.
Chelimsky, Gisela G; Yang, Sheng; Sanses, Tatiana; Tatsuoka, Curtis; Buffington, C A Tony; Janata, Jeffrey; McCabe, Patrick; Dombroski, Mary-Alice; Ialacci, Sarah; Hijaz, Adonis; Mahajan, Sangeeta; Zolnoun, Denniz; Chelimsky, Thomas C.
Afiliación
  • Chelimsky GG; Department of Pediatric Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin.
  • Yang S; Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
  • Sanses T; Department of Obstetrics and Gynecology, Howard University College of Medicine, Washington, District of Columbia.
  • Tatsuoka C; Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
  • Buffington CAT; Department of Medicine and Epidemiology, School of Veterinary Medicine, UC Davis, Davis, California.
  • Janata J; Department of Psychiatry, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
  • McCabe P; Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
  • Dombroski MA; Department of Pediatric Gastroenterology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
  • Ialacci S; Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, Ohio.
  • Hijaz A; Department of Urology, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
  • Mahajan S; Department of Urology, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
  • Zolnoun D; Department of Obstetrics and Gynecology, UNC School of Medicine, Chapel Hill, North Carolina.
  • Chelimsky TC; Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Neurourol Urodyn ; 38(5): 1370-1377, 2019 06.
Article en En | MEDLINE | ID: mdl-30945780
AIMS: The neuropathophysiology of a debilitating chronic urologic pain condition, bladder pain syndrome (BPS), remains unknown. Our recent data suggests withdrawal of cardiovagal modulation in subjects with BPS, in contrast to sympathetic nervous system dysfunction in another chronic pelvic pain syndrome, myofascial pelvic pain (MPP). We evaluated whether comorbid disorders differentially associated with BPS vs MPP shed additional light on these autonomic differences. METHODS: We compared the presence and relative time of onset of 27 other medical conditions in women with BPS, MPP, both syndromes, and healthy subjects. Analysis included an adjustment for multiple comparisons. RESULTS: Among 107 female subjects (BPS alone = 32; BPS with MPP = 36; MPP alone = 9; healthy controls = 30), comorbidities differentially associated with BPS included irritable bowel syndrome (IBS), dyspepsia, and chronic nausea, whereas those associated with MPP included migraine headache and dyspepsia, consistent with the distinct autonomic neurophysiologic signatures of the two disorders. PTSD (earliest), anxiety, depression, migraine headache, fibromyalgia, chronic fatigue, and IBS usually preceded BPS or MPP. PTSD and the presence of both pelvic pain disorders in the same subject correlated with significantly increased comorbid burden. CONCLUSIONS: Our study suggests a distinct pattern of comorbid conditions in women with BPS. These findings further support our hypothesis of primary vagal defect in BPS as compared with primary sympathetic defect in MPP, suggesting a new model for chronic these pelvic pain syndromes. Chronologically, PTSD, migraine, dysmenorrhea, and IBS occurred early, supporting a role for PTSD or its trigger in the pathophysiology of chronic pelvic pain.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistema Nervioso Autónomo / Dolor Pélvico / Cistitis Intersticial / Síndromes del Dolor Miofascial Tipo de estudio: Prognostic_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Neurourol Urodyn Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sistema Nervioso Autónomo / Dolor Pélvico / Cistitis Intersticial / Síndromes del Dolor Miofascial Tipo de estudio: Prognostic_studies Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Middle aged Idioma: En Revista: Neurourol Urodyn Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos