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Case Western Reserve University receives $3.7M NIH grant to study autonomic nervous system link to painful bladder syndrome

CLEVELAND July 23, 2009 Case Western Reserve University School of Medicine has received a $3.7 million grant from the National Institutes of Health to determine if painful bladder syndrome may be caused by abnormalities in the autonomic nervous system rather than in the bladder itself.

Principal investigator of the project is Thomas Chelimsky, M.D., professor of neurology at the Case Western Reserve University School of Medicine, and director of autonomic disorders at University Hospitals Case Medical Center and the University Hospitals Neurological Institute.

Sites participating in the five-year study are University Hospitals (Drs. Chelimsky and Jeffrey Janata), The Ohio State University (Dr. Tony Buffington), Cleveland Clinic (D. Ray Rackley), and Summa Health System (Dr. Brad Fenton).

Interstitial cystitis/painful bladder syndrome (IC/PBS) causes severe bladder pain and extensive disability in a large group of young women in the prime of their productive lives. The cause of IC/PBS remains unknown, and there is no cure. Symptoms may vary, but women with it may experience mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area. Symptoms may include an urgent need to urinate, a frequent need to urinate, or a combination of these symptoms.

"We have found that other autonomic disorders often occur in both the patients themselves and in the family members of patients with IC/PBS. We therefore propose to determine whether the main abnormality in IC/PBS actually lies in the autonomic nervous system rather than the bladder itself," said Dr. Chelimsky.

The autonomic nervous system is in charge of all internal organs such as the bowel, the bladder, blood pressure and heart rate. For obvious reasons, diseases that affect the autonomic nervous system are sometimes misdiagnosed as diseases of the internal organ itself.

"IC/PBS may actually be a member of a larger family of disorders that share a family predisposition for abnormal central autonomic and sensory responses to stress, pain or threat, usually first appearing following a traumatic event such as infection and injury," continued Dr. Chelimsky.

In the new study, the researchers will do this through measurements of autonomic function and sensation in patients who have IC/PBS, both at rest, and under controlled psychological stress. These research subjects will be compared with healthy patients, and patients with chronic pelvic pain without IC/PBS.

"We've designed the study to lead to a better understanding of the causes for this condition and to lead to possible suggestions for new treatments," said Dr. Chelimsky.


Contact: Christina DeAngelis
Case Western Reserve University

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