The University of Michigan is ideally poised to house a MAPP Discovery Site. The faculty of the Chronic Pain and Fatigue Research Center (CPFRC) are internationally known for translational research in fibromyalgia (FM) and related illnesses, including interstitial cystitis/painful bladder syndrome (IC/PBS). The Center has begun collaborating with a strong group of colleagues from the DM Urology Department. These investigators have expertise that spans the translational """"""""bench to community"""""""" continuum of IC and chronic pelvic pain. All of our projects will pursue a unifying hypothesis that we feel has been supported in related pain conditions and may underlie IC/PBS: A subset of women with IC/PBS has a """"""""central"""""""" problem in pain or sensory processing, as occurs in FM, rather than a disorder confined to the bladder. Project one extends the ongoing NIH-funded RICE study (a cross-sectional epidemiological study that queries individuals in the U.S. regarding their current symptoms). This study will 1) examine the natural history of IC/PBS in the general population, 2) show that IC/PBS patients in tertiary care clinical samples have higher rates of co-morbid conditions, including psychological co-morbidities, than IC/PBS patients in the population, and will also identify a population-based cohort of IC/PBS patients in the Michigan region that can be recruited for studies at our discovery site. Project two will perform experimental sensory testing and functional neuroimaging in women with IC/PBS, healthy controls, and FM patients. We hypothesize that IC/PBS patients are diffusely sensitive to pain and other sensory stimuli, similar to FM patients. Project three will further explore the precise reason(s) for the augmented pain and sensory processing seen in IC/PBS. A specific molecular probe will test whether a subset of IC/PBS patients has attenuated descending analgesic activity that is restored via administration of a selective noradrenergic/serotonergic reuptake inhibitor (NSRI), milnacipran. We hypothesize that we will show via experimental pain testing and functional neuroimaging that there is attenuated descending analgesic activity in some IC/PBS patients, and that improvements in these experimental parameters will be accompanied by improvement in pain and urinary urgency/frequency. We also hypothesize that certain genetic polymorphisms in COMT and beta-2 and-3 adrenoreceptors will predict the magnitude of the descending analgesic response, and response to a NSRI.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZDK1-GRB-G (M1))
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Mullins, Christopher V
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University of Michigan Ann Arbor
Schools of Medicine
Ann Arbor
United States
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Naliboff, Bruce D; Stephens, Alisa J; Lai, H Henry et al. (2017) Clinical and Psychosocial Predictors of Urological Chronic Pelvic Pain Symptom Change in 1 Year: A Prospective Study from the MAPP Research Network. J Urol 198:848-857
Lai, H Henry; Jemielita, Thomas; Sutcliffe, Siobhan et al. (2017) Characterization of Whole Body Pain in Urological Chronic Pelvic Pain Syndrome at Baseline: A MAPP Research Network Study. J Urol 198:622-631
Kutch, Jason J; Labus, Jennifer S; Harris, Richard E et al. (2017) Resting-state functional connectivity predicts longitudinal pain symptom change in urologic chronic pelvic pain syndrome: a MAPP network study. Pain 158:1069-1082
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
Harte, Steven E; Ichesco, Eric; Hampson, Johnson P et al. (2016) Pharmacologic attenuation of cross-modal sensory augmentation within the chronic pain insula. Pain 157:1933-45
Williams, David A (2016) Cognitive - Behavioral Therapy in Central Sensitivity Syndromes. Curr Rheumatol Rev 12:2-12
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
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
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
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

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