Patients with painful bladder syndrome have altered response to thermal stimuli and catastrophic reaction to painful experiences

Lior Lowenstein, Kimberly Kenton, Elizabeth R. Mueller, Linda Brubaker, Mary Heneghan, Judith Senka, Mary Pat FitzGerald*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Aims: To compare cutaneous sensory thresholds, habituation to somatic stimuli, and tendency towards catastrophic reaction to painful stimuli in patients with Painful Bladder Syndrome (PBS) to controls without PBS. Method: Thermal and vibratory sensory thresholds were established in 11 PBS patients and 10 controls at C5, T1, T12, and S3 dermatomes. Supra-threshold thermal stimuli were then applied at T12 and S3 for 60 sec while patients periodically rated the intensity of stimuli using a visual analog scale. A Pain Catastrophizing Scale (PCS) questionnaire was also completed by all participants before testing. Results: PBS patients were less sensitive to warm stimuli in the T12 dermatome than asymptomatic controls (thresholds 36.6 ± 1.10°C vs. 35.3 ± 1.0°C, P < 0.02) but otherwise had similar thermal and vibratory thresholds. Habituation to supra-threshold stimuli at T12 and S3 dermatomes was more common in controls than PBS subjects (7 (70%) vs. 2 (18%), P < 0.03 and 9 (90%) vs. 3 (27%), P < 0.008, respectively). The PCS score correlated with the duration of PBS symptoms and with thresholds to warm stimuli at T12 dermatome (ρ = 0.65, P < 0.03 and r = 0.5, P < 0.021, respectively). Conclusion: Our data suggests that habituation to stimuli may be impaired and that a catastrophic reaction to perceived stimuli may be involved in the sensory experience of PBS patients and facilitate chronic pain.

Original languageEnglish (US)
Pages (from-to)400-404
Number of pages5
JournalNeurourology and Urodynamics
Volume28
Issue number5
DOIs
StatePublished - 2009

Keywords

  • Habituation
  • Pain catastrophizing
  • Painful bladder syndrome
  • Quantitative sensory testing
  • Threshold

ASJC Scopus subject areas

  • Clinical Neurology
  • Urology

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