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Pelvic Pain May Induce Microscopic Changes in the Brain Over Time

Woodworth D, Mayer E, Leu K, Ashe-McNalley C, Naliboff BD, Labus JS, Tillisch K, Kutch JJ, Farmer MA, Apkarian AV, Johnson KA, Mackey SC, Ness TJ, Landis JR, Deutsch G, Harris RE, Clauw DJ, Mullins C, Ellingson BM; MAPP Research Network. Unique Microstructural Changes in the Brain Associated with Urological Chronic Pelvic Pain Syndrome (UCPPS) Revealed by Diffusion Tensor MRI, Super-Resolution Track Density Imaging, and Statistical Parameter Mapping: A MAPP Network Neuroimaging Study. PLoS One. 2015 Oct 13;10(10):e0140250. doi: 10.1371/journal.pone.0140250. eCollection 2015.

Some researchers suspect that over time, pain syndromes may induce microscopic changes in brain structure that influence how patients experience and process pain. To test this, investigators in the MAPP Research Network used sophisticated brain imaging techniques to look for microstructural differences in the brains of patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) or interstitial cystitis/bladder pain syndrome (IC/BPS). They found that, compared to healthy control subjects, patients with CP/CPPS or IC/BPS had extensive microstructural changes in the brain. Interestingly, they also looked at a group of patients with irritable bowel syndrome–another disorder frequently associated with pain–and found that the brain changes in the pelvic pain patients were unique and different from what they found in the IBS patients. The changes they found seemed to be located in those brain regions responsible for pain modulation (i.e. interpreting the pain signal) and perception/integration of sensations received via the senses (sight, touch, hearing, etc). The investigators suspect these changes had taken place over time due to the long-standing pain that the study subjects experienced. This isn’t the first time evidence of microscopic pain-related brain changes have been found; in previous studies, a variety of chronic pain syndromes have been associated with changes in a patient’s perception and processing of pain.