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
Clemens, J Quentin; Stephens-Shields, Alisa; Naliboff, Bruce D et al. (2018) Correlates of Health Care Seeking Activities in Patients with Urological Chronic Pelvic Pain Syndromes: Findings from the MAPP Cohort. J Urol 200:136-140
Schrepf, Andrew; Naliboff, Bruce; Williams, David A et al. (2018) Adverse Childhood Experiences and Symptoms of Urologic Chronic Pelvic Pain Syndrome: A Multidisciplinary Approach to the Study of Chronic Pelvic Pain Research Network Study. Ann Behav Med 52:865-877
Yang, Wenbin; Searl, Timothy J; Yaggie, Ryan et al. (2018) A MAPP Network study: overexpression of tumor necrosis factor-? in mouse urothelium mimics interstitial cystitis. Am J Physiol Renal Physiol 315:F36-F44
Yang, Wenbin; Yaggie, Ryan E; Jiang, Mingchen C et al. (2018) Acyloxyacyl hydrolase modulates pelvic pain severity. Am J Physiol Regul Integr Comp Physiol 314:R353-R365
Sutcliffe, Siobhan; Jemielita, Thomas; Lai, H Henry et al. (2018) A Case-Crossover Study of Urological Chronic Pelvic Pain Syndrome Flare Triggers in the MAPP Research Network. J Urol 199:1245-1251
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
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
Kutch, Jason J; Ichesco, Eric; Hampson, Johnson P et al. (2017) Brain signature and functional impact of centralized pain: a multidisciplinary approach to the study of chronic pelvic pain (MAPP) network study. Pain 158:1979-1991
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
Dagher, Adelle; Curatolo, Adam; Sachdev, Monisha et al. (2017) Identification of novel non-invasive biomarkers of urinary chronic pelvic pain syndrome: findings from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. BJU Int 120:130-142

Showing the most recent 10 out of 53 publications