Changes in Glutamate levels and Cerebral Perfusion in the limbic system of women with interstitial cystitis/bladder pain syndrome

Interstitial Cystitis/Bladder pain syndrome (IC/BPS), a chronic pain syndrome characterized by bladder pain and urinary urgency and/or frequency, is common in women. Our overall hypothesis is that increased glutamate levels in the amygdala and increased blood flow in the limbic system modulate the pain of IC/BPS. We plan to test our hypothesis by combining two non-invasive chemical and perfusion neuroimaging techniques, GluCEST and arterial spin labeling (ASL) that have been developed and validated at the Universityof Pennsylvania and provide quantitative measures of the neurotransmitter glutamate and cerebral perfusion in difficult to image subcortical structures such as the amygdala. We plan to measure clinical symptoms (using MAPP instruments), glutamate levels in the amygdala (using GluCEST) and cerebral perfusion (using ASL) inkey areas of the limbic system including the amygdala, hippocampus, anterior cingulate cortex, insula and prefrontal cortex in 24 women with IC/BPS and 24 age-matched controls before and after provoked urinary pain.