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间质性膀胱炎/膀胱疼痛综合征女性患者盆腔皮节的感觉图谱

Sensory mapping of pelvic dermatomes in women with interstitial cystitis/bladder pain syndrome.

作者信息

Sanses Tatiana, McCabe Patrick, Zhong Ling, Taylor Aisha, Chelimsky Gisela, Mahajan Sangeeta, Buffington Tony, Hijaz Adonis, Ialacci Sarah, Janata Jeffrey, Chelimsky Thomas

机构信息

University of Maryland School of Medicine, Baltimore, Maryland.

Case Western Reserve University, Cleveland, Ohio.

出版信息

Neurourol Urodyn. 2018 Jan;37(1):458-465. doi: 10.1002/nau.23330. Epub 2017 Jun 19.

Abstract

AIM

To describe a sensory map of pelvic dermatomes in women with Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS). We hypothesized that if IC/BPS involves changes in central processing, then women with IC/BPS will exhibit sensory abnormalities in neurologic pelvic dermatomes.

METHODS

Women with IC/BPS and healthy controls underwent neurologic examination that included evaluation of sharp pain sensitivity and vibration in dermatomes T12, L1, L2, S1-5. Peripheral nervous system sensitivity to pressure, vibration, and pinprick were scored using numeric rating scales (NRS). Bilateral comparisons were made with Wilcoxon signed-rank test and comparisons between groups were made by the Mann-Whitney U-test.

RESULTS

Total of 74 women with IC/BPS and 36 healthy counterparts were included. IC/BPS and control groups had similar age (43.0 ± 14.1 and 38.6 ± 15.3 years, P = 0.14) and BMI (28.9 ± 8.0 kg/m and 26.9 ± 8.4 kg/m , P = 0.24), respectively. Women with IC/BPS reported hyperalgesia (elevated bilateral NRS pain intensity) in all pelvic dermatomes compared to healthy controls. S4-S5 region had the highest pain intensity in all participants. All IC/BPS participants exhibited vibration sensation hypoesthesia, at least unilaterally, in all of the pelvic dermatomes except L1 compared to healthy controls.

CONCLUSION

This detailed map of neurologic pelvic dermatomes in women with IC/BPS found hyperalgesia in all pelvic dermatomes, and some evidence of vibration sensation hypoesthesia, compared to healthy controls. These findings support the hypothesis that IC/BPS may involve changes in central signal processing biased towards nociception.

摘要

目的

描绘间质性膀胱炎/膀胱疼痛综合征(IC/BPS)女性患者盆腔皮节的感觉图谱。我们假设,如果IC/BPS涉及中枢处理的变化,那么IC/BPS女性患者在神经盆腔皮节将表现出感觉异常。

方法

IC/BPS女性患者和健康对照者接受神经学检查,包括评估T12、L1、L2、S1 - 5皮节的锐痛敏感性和振动觉。使用数字评定量表(NRS)对周围神经系统对压力、振动和针刺的敏感性进行评分。采用Wilcoxon符号秩检验进行双侧比较,采用Mann - Whitney U检验进行组间比较。

结果

共纳入74例IC/BPS女性患者和36例健康对照者。IC/BPS组和对照组年龄相似(分别为43.0±14.1岁和38.6±15.3岁,P = 0.14),体重指数也相似(分别为28.9±8.0kg/m²和26.9±8.4kg/m²,P = 0.24)。与健康对照者相比,IC/BPS女性患者在所有盆腔皮节均报告有痛觉过敏(双侧NRS疼痛强度升高)。S4 - S5区域在所有参与者中疼痛强度最高。与健康对照者相比,所有IC/BPS参与者在除L1外的所有盆腔皮节均至少单侧表现出振动觉减退。

结论

与健康对照者相比,IC/BPS女性患者神经盆腔皮节的这一详细图谱显示所有盆腔皮节均有痛觉过敏,以及一些振动觉减退的证据。这些发现支持了IC/BPS可能涉及偏向伤害性感受的中枢信号处理变化这一假设。

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