Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common and often debilitating condition. The underlying cause of CP/CPPS remains unknown. We recently published the first neuroimaging study comparing men with CP/CPPS to healthy men. We found that the functional connectivity between a brain motor region which activates pelvic floor muscles (a region of interest that we term pelvic-motor) and a sensory region associated with the viscera (which we uncovered to be the right posterior insula) was significantly reduced in men with CP/CPPS compared to healthy men. This prior work suggests that understanding this sensorimotor functional connection (which we term pelvic-motor/insula functional connectivity) may be critical to understanding the pathophysiology of CP/CPPS. However, we still do not fundamentally know how resting brain function influences sensorimotor control. In the proposed work, we aim to fill this knowledge gap by relating pelvic-motor/insula functional connectivity to automatic pelvic floor muscle activation during voluntary activation of non-pelvic floor muscles in men with and without CP/CPPS. This work will be approached in two complementary Aims. Pelvic-motor/insula functional connectivity will be quantified for each individual using resting state functional magnetic resonance imaging (rsfMRI). Automatic pelvic floor muscle activation will be quantified using surface electromyography (EMG) during voluntary activation of the gluteus maximus muscle. In Aim 1, we will study inter-individual differences in healthy men and determine if reduced pelvic-motor/insula functional connectivity correlates with increases in the magnitude of automatic pelvic floor muscle activation during voluntary activation of non-pelvic floor muscles. In Aim 2, we will study men with CP/CPPS (whom we have shown have a reduced value of resting state pelvic-motor/insula functional connectivity compared to healthy controls) and determine if men with CP/CPPS show corresponding increases in the magnitude of automatic pelvic floor muscle activation during voluntary activation of the gluteus maximus muscle. This work, to our knowledge, represents the first study relating resting brain function to the magnitude of automatic muscle activation. This work is also the first study proposing to test a specific mechanism of altered pelvic floor muscle control in men with CP/CPPS. This work has the potential to significantly impact our understanding of how normal functional brain connections determine motor control. The work also has the potential to greatly advance our knowledge of CP/CPPS pathophysiology, by determining if men with CP/CPPS exhibit changes in motor control at both the brain and muscle level.
|Effective start/end date||2/1/17 → 3/31/21|
- University of Southern California (85596622//5R01DK110669-03 REVISED)
- National Institute of Diabetes and Digestive and Kidney Diseases (85596622//5R01DK110669-03 REVISED)