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Interstitial Cystitis - Elucidation of Psychophysiologic and Autonomic Characteristics (the ICEPAC Study): design and methods.

Chelimsky T, Chelimsky G, McCabe NP, Louttit M, Hijaz A, Mahajan S, Sanses T, Buffington CT, Fenton B, Janicki T, Ialacci S, Veizi E, Zhang D, Daneshgari F, Elston R, Janata J - J Pain Res (2014)

Bottom Line: Interstitial cystitis/bladder pain syndrome (IC/BPS) is relatively common and associated with severe pain, yet effective treatment remains elusive.The study represents a comprehensive, interdisciplinary approach to sampling autonomic and psychophysiologic characteristics of women with IC/BPS.Despite divergent opinions on study methodologies based on specialty experiences, the study has proven feasible to date and different perspectives have proved to be one of the greatest study strengths.

View Article: PubMed Central - PubMed

Affiliation: The Medical College of Wisconsin, Departments of Neurology and Gastroenterology, Milwaukee, WI, USA.

ABSTRACT

Background and purpose: Interstitial cystitis/bladder pain syndrome (IC/BPS) is relatively common and associated with severe pain, yet effective treatment remains elusive. Research typically emphasized the bladder's role, but given the high presence of systemic comorbidities, the authors hypothesized a pathophysiologic nervous system role. This paper reports the methodology and approach to study the nervous system in women with IC/BPS. The study compares neurologic, urologic, gynecologic, autonomic, gastrointestinal, and psychological features of women with IC/BPS, their female relatives, women with myofascial pelvic pain (MPP), and healthy controls to elucidate the role of central and peripheral processing.

Methods and results: In total, 228 women (76 IC/BPS, 76 MPP, 38 family members, and 38 healthy controls) will be recruited. Subjects undergo detailed screening, structured neurologic examination of limbs and pelvis, tender point examination, autonomic testing, electrogastrography, and assessment of comorbid functional dysautonomias. Interpreters are blinded to subject classification. Psychological and stress response characteristics are examined with assessments of stress, trauma history, general psychological function, and stress response quantification. As of December 2012, data collection is completed for 25 healthy controls, 33 IC/BPS ± MPP, eight MPP, and three family members. Recruitment rate is accelerating and strategies emphasize maintaining and encouraging investigator participation in study science, internet advertising, and presentations to pelvic pain support groups.

Conclusion: The study represents a comprehensive, interdisciplinary approach to sampling autonomic and psychophysiologic characteristics of women with IC/BPS. Despite divergent opinions on study methodologies based on specialty experiences, the study has proven feasible to date and different perspectives have proved to be one of the greatest study strengths.

No MeSH data available.


Related in: MedlinePlus

ICEPAC data collection form for SFIBS examination.Note: The SFIBS exam assesses generalized small (and large) fiber peripheral nerve dysfunction and any evidence of disordered motor control or sensory–motor coordination.Abbreviations: ICEPAC, Interstitial Cystitis: Elucidation of Psychophysiologic and Autonomic Characteristics; SFIBS, Small Fiber Score.
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f5-jpr-7-243: ICEPAC data collection form for SFIBS examination.Note: The SFIBS exam assesses generalized small (and large) fiber peripheral nerve dysfunction and any evidence of disordered motor control or sensory–motor coordination.Abbreviations: ICEPAC, Interstitial Cystitis: Elucidation of Psychophysiologic and Autonomic Characteristics; SFIBS, Small Fiber Score.

Mentions: The remainder of Visit 2 is performed in a standard examination room. The 3-day voiding diary is collected from the subject and reviewed. A water load test26 is administered, which consists of recording the maximal volume of water a subject can consume in 5 minutes with comparison to normal values. Subjects classified as IC/BPS, MPP, or family members then undergo a fibromyalgia examination based on the 1990 American College of Rheumatology22 criteria, checking the 18 standard tender points applying 4 kg of pressure with the thumb, calibrated using an algometer every fourth point. An examination of the extremities (Small Fiber Score) looking for generalized small (and large) fiber peripheral nerve dysfunction is performed assessing pin, temperature, vibration sensation, superficial and deep allodynia, distal muscle strength, and reflexes (Figure 5). A pelvic neurologic examination27 is performed to evaluate dermatomes T12, L1, L2, S1, S2, S3, S4, and S5 for pin prick and vibration sensations. Subjects are compensated for their time and offered participation in other ICEPAC substudies such as the Trier Social Stress Test study28 or an ICEPAC sleep study investigating sleep disorders in women with IC/BPS.


Interstitial Cystitis - Elucidation of Psychophysiologic and Autonomic Characteristics (the ICEPAC Study): design and methods.

Chelimsky T, Chelimsky G, McCabe NP, Louttit M, Hijaz A, Mahajan S, Sanses T, Buffington CT, Fenton B, Janicki T, Ialacci S, Veizi E, Zhang D, Daneshgari F, Elston R, Janata J - J Pain Res (2014)

ICEPAC data collection form for SFIBS examination.Note: The SFIBS exam assesses generalized small (and large) fiber peripheral nerve dysfunction and any evidence of disordered motor control or sensory–motor coordination.Abbreviations: ICEPAC, Interstitial Cystitis: Elucidation of Psychophysiologic and Autonomic Characteristics; SFIBS, Small Fiber Score.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4020893&req=5

f5-jpr-7-243: ICEPAC data collection form for SFIBS examination.Note: The SFIBS exam assesses generalized small (and large) fiber peripheral nerve dysfunction and any evidence of disordered motor control or sensory–motor coordination.Abbreviations: ICEPAC, Interstitial Cystitis: Elucidation of Psychophysiologic and Autonomic Characteristics; SFIBS, Small Fiber Score.
Mentions: The remainder of Visit 2 is performed in a standard examination room. The 3-day voiding diary is collected from the subject and reviewed. A water load test26 is administered, which consists of recording the maximal volume of water a subject can consume in 5 minutes with comparison to normal values. Subjects classified as IC/BPS, MPP, or family members then undergo a fibromyalgia examination based on the 1990 American College of Rheumatology22 criteria, checking the 18 standard tender points applying 4 kg of pressure with the thumb, calibrated using an algometer every fourth point. An examination of the extremities (Small Fiber Score) looking for generalized small (and large) fiber peripheral nerve dysfunction is performed assessing pin, temperature, vibration sensation, superficial and deep allodynia, distal muscle strength, and reflexes (Figure 5). A pelvic neurologic examination27 is performed to evaluate dermatomes T12, L1, L2, S1, S2, S3, S4, and S5 for pin prick and vibration sensations. Subjects are compensated for their time and offered participation in other ICEPAC substudies such as the Trier Social Stress Test study28 or an ICEPAC sleep study investigating sleep disorders in women with IC/BPS.

Bottom Line: Interstitial cystitis/bladder pain syndrome (IC/BPS) is relatively common and associated with severe pain, yet effective treatment remains elusive.The study represents a comprehensive, interdisciplinary approach to sampling autonomic and psychophysiologic characteristics of women with IC/BPS.Despite divergent opinions on study methodologies based on specialty experiences, the study has proven feasible to date and different perspectives have proved to be one of the greatest study strengths.

View Article: PubMed Central - PubMed

Affiliation: The Medical College of Wisconsin, Departments of Neurology and Gastroenterology, Milwaukee, WI, USA.

ABSTRACT

Background and purpose: Interstitial cystitis/bladder pain syndrome (IC/BPS) is relatively common and associated with severe pain, yet effective treatment remains elusive. Research typically emphasized the bladder's role, but given the high presence of systemic comorbidities, the authors hypothesized a pathophysiologic nervous system role. This paper reports the methodology and approach to study the nervous system in women with IC/BPS. The study compares neurologic, urologic, gynecologic, autonomic, gastrointestinal, and psychological features of women with IC/BPS, their female relatives, women with myofascial pelvic pain (MPP), and healthy controls to elucidate the role of central and peripheral processing.

Methods and results: In total, 228 women (76 IC/BPS, 76 MPP, 38 family members, and 38 healthy controls) will be recruited. Subjects undergo detailed screening, structured neurologic examination of limbs and pelvis, tender point examination, autonomic testing, electrogastrography, and assessment of comorbid functional dysautonomias. Interpreters are blinded to subject classification. Psychological and stress response characteristics are examined with assessments of stress, trauma history, general psychological function, and stress response quantification. As of December 2012, data collection is completed for 25 healthy controls, 33 IC/BPS ± MPP, eight MPP, and three family members. Recruitment rate is accelerating and strategies emphasize maintaining and encouraging investigator participation in study science, internet advertising, and presentations to pelvic pain support groups.

Conclusion: The study represents a comprehensive, interdisciplinary approach to sampling autonomic and psychophysiologic characteristics of women with IC/BPS. Despite divergent opinions on study methodologies based on specialty experiences, the study has proven feasible to date and different perspectives have proved to be one of the greatest study strengths.

No MeSH data available.


Related in: MedlinePlus