title: Altered resting state neuromotor connectivity in men with chronic prostatitis/chronic pelvic pain syndrome: A MAPP: Research Network Neuroimaging Study.
abstract: Brain network activity associated with altered motor control in individuals with chronic pain is not well understood. Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a debilitating condition in which previous studies have revealed altered resting pelvic floor muscle activity in men with CP/CPPS compared to healthy controls. We hypothesized that the brain networks controlling pelvic floor muscles would also show altered resting state function in men with CP/CPPS. Here we describe the results of the first test of this hypothesis focusing on the motor cortical regions, termed pelvic-motor, that can directly activate pelvic floor muscles. A group of men with CP/CPPS (N = 28), as well as group of age-matched healthy male controls (N = 27), had resting state functional magnetic resonance imaging scans as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network study. Brain maps of the functional connectivity of pelvic-motor were compared between groups. A significant group difference was observed in the functional connectivity between pelvic-motor and the right posterior insula. The effect size of this group difference was among the largest effect sizes in functional connectivity between all pairs of 165 anatomically-defined subregions of the brain. Interestingly, many of the atlas region pairs with large effect sizes also involved other subregions of the insular cortices. We conclude that functional connectivity between motor cortex and the posterior insula may be among the most important markers of altered brain function in men with CP/CPPS, and may represent changes in the integration of viscerosensory and motor processing.
authors.affiliation: Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Kutch
authors.affiliation: Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
authors.forename: Moheb S
authors.initials: MS
authors.lastname: Yani
authors.affiliation: Physical Therapy Department, Loma Linda University, Loma Linda, CA, USA.
authors.forename: Skulpan
authors.initials: S
authors.lastname: Asavasopon
authors.affiliation: Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Kirages
authors.affiliation: Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
authors.forename: Manku
authors.initials: M
authors.lastname: Rana
authors.affiliation: Department of Psychology, University of Southern California, Los Angeles, CA, USA.
authors.forename: Louise
authors.initials: L
authors.lastname: Cosand
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, Pain and Interoception Network (PAIN), David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Labus
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, Pain and Interoception Network (PAIN), David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Kilpatrick
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, Pain and Interoception Network (PAIN), David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Cody
authors.initials: C
authors.lastname: Ashe-McNalley
authors.affiliation: Department of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Farmer
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center, Division of Pain Medicine, Stanford, CA, USA.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Johnson
authors.affiliation: Departments of Radiology and Anesthesiology, Birmingham Medical Center, University of Alabama, Birmingham, AL, USA.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Ness
authors.affiliation: Departments of Radiology and Anesthesiology, Birmingham Medical Center, University of Alabama, Birmingham, AL, USA.
authors.forename: Georg
authors.initials: G
authors.lastname: Deutsch
authors.affiliation: Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Harris
authors.affiliation: Department of Physiology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: A Vania
authors.initials: AV
authors.lastname: Apkarian
authors.affiliation: Department of Anesthesiology, Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Clauw
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University Medical Center, Division of Pain Medicine, Stanford, CA, USA.
authors.forename: Sean C
authors.initials: SC
authors.lastname: Mackey
authors.affiliation: National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Mullins
authors.affiliation: Oppenheimer Center for Neurobiology of Stress, Pain and Interoception Network (PAIN), David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Emeran A
authors.initials: EA
authors.lastname: Mayer
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015331:Cohort Studies; D059907:Functional Neuroimaging / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D009415:Nerve Net / Q000503:physiopathology*; D017699:Pelvic Pain / Q000503:physiopathology*; D011472:Prostatitis / Q000503:physiopathology*