Urologic chronic pelvic pain syndromes (UCPPS) cause untold morbidity and are associated with depression. Multidisciplinary Assessment of Pelvic Pain (MAPP) has been very successful during Phase I, and Phase II promises even greater understanding of UCPPS phenotypes and the underlying mechanisms. Our team has contributed to many key Trans-MAPP initiatives, including workgroups focusing on animal models, neuroimaging, and patient-reported outcomes in UCPPS. Here, we seek to build upon these important efforts with innovative studies that go well beyond MAPP I by examining the relationship between UCPPS, its underlying mechanisms, and depression. Our site will recruit into a large Symptom Pattern Study (N = 106 per site) and follow them longitudinally to track the trajectory of pelvic pain, as well as to identify risk factors for symptom flares and exacerbations As part of the Symptom Pattern Study, patients will be characterized by presenting symptoms, biomarkers, and neuroimaging. Our site-specific proposal includes a number of neuroimaging studies to interrogate brain-periphery connections as well as to study dysregulation in risk-reward circuitry that may be relevant to pelvic pain comorbidities. To better characterize UCPPS symptoms and comorbidities, we also propose to develop a mobile-phone-based app for high- resolution monitoring of UCPPS symptoms, as well as an intense psychiatric phenotyping study in which state-of-the-art interviews are used to understand comorbid diagnoses of UCPPS patients. Finally, we propose a series of mechanistic studies using clinically relevant murine UCPPS models to define the role of TLR4 as an integrator of triggers that drive pain, voiding dysfunction, and anxiety/depression. In summary, these studies will yield a multi-dimensional understanding of UPPS phenotypes and mechanisms that set the stage for individualized and effective therapies.

Public Health Relevance

Chronic pelvic pain causes severe morbidity in women and men, yet no effective therapies exist. Here, we propose a combination of studies to be conducted within the NIDDK MAPP network and site-specific studies that will further define the chronic pelvic pain at the levels of symptoms, biomarkers, epidemiology, and underlying mechanisms.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project--Cooperative Agreements (U01)
Project #
Application #
Study Section
Special Emphasis Panel (ZDK1)
Program Officer
Mullins, Christopher V
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Northwestern University at Chicago
Schools of Medicine
United States
Zip Code
Alger, Jeffry R; Ellingson, Benjamin M; Ashe-McNalley, Cody et al. (2016) Multisite, multimodal neuroimaging of chronic urological pelvic pain: Methodology of the MAPP Research Network. Neuroimage Clin 12:65-77
Nickel, J Curtis; Stephens, Alisa; Landis, J Richard et al. (2016) Assessment of the Lower Urinary Tract Microbiota during Symptom Flare in Women with Urologic Chronic Pelvic Pain Syndrome: A MAPP Network Study. J Urol 195:356-62
Stephens-Shields, Alisa J; Clemens, J Quentin; Jemielita, Thomas et al. (2016) Symptom Variability and Early Symptom Regression in the MAPP Study: A Prospective Study of Urological Chronic Pelvic Pain Syndrome. J Urol 196:1450-1455
Huang, Lejian; Kutch, Jason J; Ellingson, Benjamin M et al. (2016) Brain white matter changes associated with urological chronic pelvic pain syndrome: multisite neuroimaging from a MAPP case-control study. Pain 157:2782-2791
Griffith, James W; Stephens-Shields, Alisa J; Hou, Xiaoling et al. (2016) Pain and Urinary Symptoms Should Not be Combined into a Single Score: Psychometric Findings from the MAPP Research Network. J Urol 195:949-54
Clemens, J Quentin; Clauw, Daniel J; Kreder, Karl et al. (2015) Comparison of baseline urological symptoms in men and women in the MAPP research cohort. J Urol 193:1554-8
Kutch, Jason J; Yani, Moheb S; Asavasopon, Skulpan et al. (2015) Altered resting state neuromotor connectivity in men with chronic prostatitis/chronic pelvic pain syndrome: A MAPP: Research Network Neuroimaging Study. Neuroimage Clin 8:493-502
Farmer, Melissa A; Huang, Lejian; Martucci, Katherine et al. (2015) Brain White Matter Abnormalities in Female Interstitial Cystitis/Bladder Pain Syndrome: A MAPP Network Neuroimaging Study. J Urol 194:118-26
Kairys, Anson E; Schmidt-Wilcke, Tobias; Puiu, Tudor et al. (2015) Increased brain gray matter in the primary somatosensory cortex is associated with increased pain and mood disturbance in patients with interstitial cystitis/painful bladder syndrome. J Urol 193:131-7
Schrepf, Andrew; Bradley, Catherine S; O'Donnell, Michael et al. (2015) Toll-like receptor 4 and comorbid pain in Interstitial Cystitis/Bladder Pain Syndrome: a multidisciplinary approach to the study of chronic pelvic pain research network study. Brain Behav Immun 49:66-74

Showing the most recent 10 out of 43 publications