Abstract Details

Title Evidence for Central Sensitization in Bladder Pain Syndrome from the ICEPAC Trial (Interstitial Cystitis: Elucidation of Psychophysiologic and Autonomic Characteristics) - Preliminary Psychometric Findings

Topic Behavioral Neurology

Presentation(s) P05 - (-)

Poster/Presentation
Number 126

Objective

Background BACKGROUND: Interstitial cystitis (IC - Bladder Pain Syndrome), is characterized by pain in the bladder worse when full and better when empty along with urgency and frequency. Despite extensive research, the pathophysiology is unknown and there is no effective treatment.

Design/Methods DESIGN/METHODS: ICEPAC completed enrollment will include 76 women with IC, 76 women with myofascial pelvic pain disorder (MPP), 38 1st degree female relatives of IC subjects without pelvic pain, and 38 healthy age-matched women. Subjects complete comprehensive psychological measures of pain, function, catastrophizing, childhood trauma, PTSD, somatization, anxiety and stress. A subset of patients also undergo a Trier stress test, with assessment of the resulting catecholaminergic and hypothalamic-pituitary response.

Results RESULTS: Initial recruitment has included 50 subjects: 22 with IC/MPP, 7 with MPP alone and 21 healthy controls. Ages ranged from 18 to 62. Compared to healthy controls, the pain groups show elevated levels of somatization, depression, anxiety, PTSD symptoms, pain catastrophizing and childhood trauma, and both groups show impairment of function. However, the IC/MPP group compared to the MPP group has significantly higher scores on childhood emotional abuse (mean=12.4 vs. 9.0), PTSD symptoms (13.3 vs. 5.1), and pain catastrophizing (28.0 vs. 16.6).

Conclusions CONCLUSIONS: These results are consistent with early exposure to trauma and subsequent central nervous system sensitization evidenced by PTSD symptoms and increased emotional processing of nociceptive input. These promising early findings require the confirmation that additional recruitment will provide. Evidence for autonomic signatures or correlates is pending continued recruitment.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
Robin L. Brey, MD (Univ of TX Hlth Science Ctr/MSC 7883)	The institution of Dr. Brey has received research support from State of Texas. Dr. Brey has a non-compensated relationship as a Task Force Member with AAN that is relevant to AAN interests or activities.
	No disclosure on file
Jennifer DeWolfe, DO (University of Alabama At Birmingham)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Thomas C. Chelimsky, MD (Medical College of Wisconsin)	Dr. Chelimsky has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Proctor & Gamble. Dr. Chelimsky has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Various Legal Firms. Dr. Chelimsky has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Various Legal Firms. Dr. Chelimsky has received stock or an ownership interest from PainSTakers, LLC. The institution of Dr. Chelimsky has received research support from NIDDK. The institution of Dr. Chelimsky has received research support from Advancing a Healthier Wisconsin.

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