Urine trouble: Alterations in brain function associated with bladder pain

PURPOSE - Chronic bladder pain is a debilitating condition often accompanied by alterations in affective and autonomic function. Many of the symptoms associated with chronic bladder pain are mediated by the central nervous system.

In this review, data from preclinical animal models and human neuroimaging studies were analyzed and a theoretical supraspinal bladder pain network was generated.

MATERIALS AND METHODS - A comprehensive literature review was performed using PubMed and Google Scholar. Relevant reviews, original research articles, and their cited references were summarized then organized on a neuroanatomical basis.

RESULTS - The following brain loci are the most predominant in the bladder pain literature: thalamus, parabrachial nucleus, cerebral cortex, amygdala, hypothalamus, periaqueductal gray, and rostral ventromedial medulla. This review highlights each of these regions, discussing the molecular and physiological changes that occur in each during the context of bladder pain.

CONCLUSIONS - A complex network of brain loci is involved in bladder pain modulation. Studying these brain regions and the changes they undergo during the transition from acute to chronic bladder pain will provide novel therapeutic strategies for those suffering from chronic bladder pain diseases such as interstitial cystitis/bladder pain syndrome (IC/BPS) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

The Journal of urology. 2016 Feb 20 [Epub ahead of print]

Katelyn E Sadler, Benedict J Kolber

Department of Biological Sciences,; Chronic Pain Research Consortium, Duquesne University, Pittsburgh, PA., Department of Biological Sciences,; Chronic Pain Research Consortium, Duquesne University, Pittsburgh, PA.