Selda Korkmaz1, Mert Ali Karadag2, Kemal Hamamcioglu3, Mustafa Sofikerim4, Murat Aksu5. 1. NIH/NINDS Human Motor Control Section, Bethesda, Maryland, USA.. korkmazs78@gmail.com. 2. Department of Urology, Kafkas University College of Medicine, Kars, Turkey. 3. Department of Neurology, Acibadem Kayseri Hospital, Kayseri, Turkey. 4. Department of Urology, Acibadem Kayseri Hospital, Acibadem University College of Medicine, Istanbul, Turkey. 5. Department of Neurology, Acibadem Kayseri Hospital, Acibadem University College of Medicine, Istanbul, Turkey.
Abstract
PURPOSE: Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a chronic pain condition and a common problem in urology clinics. Although many different etiologies and mechanisms exist, the exact cause of the disease has been unknown. Central sensitization (CS) is defined as an augmentation of responsiveness of central cortical neurons to input from peripheral nociceptive structures. Somato-sensory evoked potentials (SEPs) is an electroneurophysiological method to assess cortical activity in somatosensory area of brain related to sensorial stimuli. We aimed to determine the presence of CS using the SEPs of dorsal penile nerve stimulation in patients with CP/CPPS. MATERIALS AND METHODS: Seventeen male patients diagnosed CP/CPPS and 17 male healthy controls were prospectively included in the study. For SEP study, electrical stimulus was applied with penile ring electrodes. Recording electrodes were placed as active to Cz' and reference electrode on Fz' according to the 10-20 International System. Latency of N50 was defined as the second negative (up-ward) deflection of the W-shaped averaged cortical waveform. RESULTS: N50 latencies were significantly shortened in the patient group compared to the healthy controls (P < .001). CONCLUSION: These results support the presence of central sensitization because of exaggerated trans-mission of pain sensation to the somatosensory cortex. Therefore, normalization of transmission might be an important step in treatment of pain in patients with CP/CPPS. This study can be counted as an important guiding on pathogenesis and treatment of disease.
PURPOSE:Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a chronic pain condition and a common problem in urology clinics. Although many different etiologies and mechanisms exist, the exact cause of the disease has been unknown. Central sensitization (CS) is defined as an augmentation of responsiveness of central cortical neurons to input from peripheral nociceptive structures. Somato-sensory evoked potentials (SEPs) is an electroneurophysiological method to assess cortical activity in somatosensory area of brain related to sensorial stimuli. We aimed to determine the presence of CS using the SEPs of dorsal penile nerve stimulation in patients with CP/CPPS. MATERIALS AND METHODS: Seventeen male patients diagnosed CP/CPPS and 17 male healthy controls were prospectively included in the study. For SEP study, electrical stimulus was applied with penile ring electrodes. Recording electrodes were placed as active to Cz' and reference electrode on Fz' according to the 10-20 International System. Latency of N50 was defined as the second negative (up-ward) deflection of the W-shaped averaged cortical waveform. RESULTS: N50 latencies were significantly shortened in the patient group compared to the healthy controls (P < .001). CONCLUSION: These results support the presence of central sensitization because of exaggerated trans-mission of pain sensation to the somatosensory cortex. Therefore, normalization of transmission might be an important step in treatment of pain in patients with CP/CPPS. This study can be counted as an important guiding on pathogenesis and treatment of disease.
Authors: Maria Beatrice Passavanti; Vincenzo Pota; Pasquale Sansone; Caterina Aurilio; Lorenzo De Nardis; Maria Caterina Pace Journal: Pain Res Treat Date: 2017-11-20