title: Patients with painful bladder syndrome have altered response to thermal stimuli and catastrophic reaction to painful experiences.
abstract: OBJECTIVE
  To compare cutaneous sensory thresholds, habituation to somatic stimuli, and tendency towards catastrophic reaction to painful stimuli in patients with Painful Bladder Syndrome (PBS) to controls without PBS.
  
  
  METHODS
  Thermal and vibratory sensory thresholds were established in 11 PBS patients and 10 controls at C5, T1, T12, and S3 dermatomes. Supra-threshold thermal stimuli were then applied at T12 and S3 for 60 sec while patients periodically rated the intensity of stimuli using a visual analog scale. A Pain Catastrophizing Scale (PCS) questionnaire was also completed by all participants before testing.
  
  
  RESULTS
  PBS patients were less sensitive to warm stimuli in the T12 dermatome than asymptomatic controls (thresholds 36.6 +/- 1.10 degrees C vs. 35.3 +/- 1.0 degrees C, P < 0.02) but otherwise had similar thermal and vibratory thresholds. Habituation to supra-threshold stimuli at T12 and S3 dermatomes was more common in controls than PBS subjects (7 (70%) vs. 2 (18%), P < 0.03 and 9 (90%) vs. 3 (27%), P < 0.008, respectively). The PCS score correlated with the duration of PBS symptoms and with thresholds to warm stimuli at T12 dermatome (rho = 0.65, P < 0.03 and rho = 0.5, P < 0.021, respectively).
  
  
  CONCLUSIONS
  Our data suggests that habituation to stimuli may be impaired and that a catastrophic reaction to perceived stimuli may be involved in the sensory experience of PBS patients and facilitate chronic pain. Neurourol. Urodyn. 28:400-404, 2009. (c) 2009 Wiley-Liss, Inc.
authors.affiliation: Division of Female Pelvic Medicine & Reconstructive Surgery, Departments of Obstetrics & Gynecology and Urology, Loyola University Stritch School of Medicine, Maywood, Illinois, USA.
authors.forename: Lior
authors.initials: L
authors.lastname: Lowenstein
authors.forename: Kimberly
authors.initials: K
authors.lastname: Kenton
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Mueller
authors.forename: Linda
authors.initials: L
authors.lastname: Brubaker
authors.forename: Mary
authors.initials: M
authors.lastname: Heneghan
authors.forename: Judith
authors.initials: J
authors.lastname: Senka
authors.forename: Mary Pat
authors.initials: MP
authors.lastname: Fitzgerald
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D018856:Cystitis, Interstitial / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006185:Habituation, Psychophysiologic; D006358:Hot Temperature; D006801:Humans; D006930:Hyperalgesia / Q000503:physiopathology*; D016014:Linear Models; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold; D010465:Perception; D012867:Skin / Q000294:innervation*; D011795:Surveys and Questionnaires; D014732:Vibration; D055815:Young Adult