Autonomic testing of women with interstitial cystitis/bladder pain syndrome

Autor: Lu Zhang, N. Patrick McCabe, Robert C. Elston, Gisela Chelimsky, Sarah Ialacci, Jeffrey W. Janata, Thomas C. Chelimsky
Rok vydání: 2014
Předmět:
Adult
medicine.medical_specialty
Urinary urgency
Neurology
Valsalva Maneuver
medicine.medical_treatment
030232 urology & nephrology
Urology
Clinical Neurology
Cystitis
Interstitial
Pain
urologic and male genital diseases
Autonomic Nervous System
03 medical and health sciences
0302 clinical medicine
Interstitial cystitis/bladder pain syndrome
Pelvic pain
Heart Rate
Tilt-Table Test
Reflex
medicine
Valsalva maneuver
Nocturia
Humans
Prospective Studies
business.industry
Endocrine and Autonomic Systems
Urinary Bladder Diseases
Interstitial cystitis
Middle Aged
medicine.disease
female genital diseases and pregnancy complications
Axons
Autonomic nervous system
Female
Neurology (clinical)
medicine.symptom
Urinary bladder disease
business
hormones
hormone substitutes
and hormone antagonists
030217 neurology & neurosurgery
Research Article
Zdroj: Clinical Autonomic Research
ISSN: 1619-1560
Popis: Purpose Interstitial cystitis/bladder pain syndrome (IC/BPS) is characterized by urinary urgency, frequency, nocturia, pain worse as the bladder fills and improved after emptying. These features might suggest abnormal autonomic bladder control mechanisms. We compared the structural integrity of the autonomic nervous system (ANS) in IC/BPS and control subjects. Methods IRB-approved study at University Hospitals Case Medical Center, Cleveland, OH to evaluate the structural integrity of the ANS in adult females. Testing included cardiovascular response to deep breathing, Valsalva maneuver, 30 min head up tilt, and sudomotor test. Results Differences in ANS integrity for IC/BPS subjects and controls were determined by modified Composite Autonomic Severity Score (CASS) that includes sudomotor, adrenergic and cardiovascular indices. Baseline heart rate (HR) and HRs from each of three 10 min upright segments of a tilt test were compared and trend analyses performed using t tests. Healthy and IC/BPS subjects were demographically similar. The two groups did not differ in modified-CASS scores but elevated average peak heart rate was evident during baseline (supine; p = 0.057) for IC/BPS subjects prior to a tilt test. Difference at baseline was maintained at each interval during the tilt, with nearly identical slopes across intervals. The preliminary nature of this report denotes a small sample size and important differences may not be detected. Conclusions The findings show no structural ANS abnormalities in IC/BPS subjects. Higher baseline HR supports the concept of functional rather than structural change in the ANS, such as abnormality of sympathetic/parasympathetic balance that will require further evaluation.
Databáze: OpenAIRE
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