U.S. Department of Health and Human Services

Brain Region Changes Associated with Symptoms in Women with Interstitial Cystitis

​A new study suggests that enlargement of certain brain regions is associated with symptoms in women with interstitial cystitis. Interstitial cystitis (IC), also called IC/painful bladder syndrome (PBS), is a urologic chronic pelvic pain syndrome whose symptoms include urinary urgency, frequency, and pelvic pain. The causes and risk factors for IC are not well understood, and there is no fully effective treatment. Researchers in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network are using a variety of scientific approaches to better understand IC and similar pain syndromes and lay the groundwork for development of clinical interventions to prevent and treat these conditions. An important aspect of chronic pain studies is the emerging understanding that different parts of the brain may become altered in a way that augments and/or maintains the experience of pain. Network researchers used a sophisticated brain imaging technique to determine whether there are differences in the volume of gray matter—the core component of brain tissue—between women with IC and those without, and whether those differences align with symptoms. Comparing results from 33 women with IC and 33 women without IC, the team found several brain regions in which women with IC had a significantly greater volume of gray matter, three of which are involved in pain processing. Further, the scientists found that greater gray matter volume in one pain-processing brain region, called the right S1, was associated with greater symptoms of overall pain, urinary urgency, and anxiety reported by women with IC on the day of the brain scan. This is the first study to show regional brain differences between women with IC and healthy counterparts. Future studies may help researchers understand the relationship between altered brain regions and pain sensitivity in IC patients, as well as the impact of other variables, such as co-occurring pain conditions and gender, on these brain changes. 

Kairys AE, Schmidt-Wilcke T, Puiu T, Ichesco E, Labus JS, Martucci K, Farmer MA, Ness TJ, Deutsch G, Mayer EA, Mackey S, Apkarian AV, Maravilla K, Clauw DJ, Harris RE.  Increased brain gray matter in the primary somatosensory cortex is associated with increased pain and mood disturbance in interstitial cystitis/painful bladder syndrome patients. J Urol 193: 131-137, 2015.