[Associations between the efficiency of the brain white matter network and clinical symptoms in patients with type â ¢ B prostatitis].

OBJECTIVE: To investigate the changes in the topological properties of the global and local nodal efficiencies of the brain white matter network in patients with type III B prostatitis, and to analyze the correlation between the information transmission efficiency of different brain regions and pelvic pain. METHODS: We enrolled 19 patients with type Ⅲ B prostatitis and 32 normal controls matched in general demographic data for this study. We assessed the pelvic pain of the patients based on the NIH-CPSI, obtained the structural and diffusion-weighted MR images of the brain, preprocessed the MRI data, constructed the brain structural networks and calculated the topological properties of the nodal local and global efficiencies using the FSL software package and brain connection toolbox. Finally, we compared the topological properties between the two groups by t-test with the SPSS 20 software, performed multiple correction of the values using the false discovery rate (FDR) method, and investigated the associations of the altered brain regions with the NIH-CPSI scores by Pearson correlation analysis. RESULTS: The global efficiency of the orbital part of the right median frontal gyrus in the patients with type Ⅲ B prostatitis, compared with that in the normal controls, was dramatically decreased (0.095 ± 0.046 vs 0.13 ± 0.015, P < 0.01) while that of the left median cingulate gyrus markedly increased (0.16 ± 0.027 vs 0.14 ± 0.019, P < 0.01), which were corrected by FDR. The local efficiency of the left median cingulate gyrus was also remarkably decreased in the patients as compared with that in the controls (0.25 ± 0.075 vs 0.19 ± 0.036, P < 0.01), and so was that of the left paracentral lobule (0.25 ± 0.088 vs 0.17 ± 0.065, P < 0.01), which were corrected by FDR. In the patients, the local efficiencies of the left precuneus (r = 0.46, P = 0.045), right supplementary motor area (r = 0.47, P = 0.043) and left median cingulate gyrus (r = 0.60, P = 0.0065) were positively correlated with the total score of NIH-CPSI, the scores of pain and discomfort symptoms, and the scores of the influence of the symptoms on the quality of life. CONCLUSIONS: The changes of the brain regions in the executive control network of the patient with type Ⅲ B prostatitis might be involved in enhancing his sensitivity to pain and discomfort, and consequently lead to pelvic pain and discomfort.

[Acupuncture therapy for chronic prostatitis / chronic pelvic pain syndrome and its central neural mechanisms].

Chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) is one of the common diseases in andrology, with the main clinical symptoms of long-term and repeated pain or discomfort in the pelvic region. Acupuncture has been widely used in the treatment of CP/CPPS-related pelvic pain and discomfort with rapid and long-lasting effects, and its combination with Western medicine can produce an even better effect than Western medicine alone. At present, various theories have been advanced on the action mechanisms of the acupuncture therapy for CP/CPPS, involving immunoregulation, improvement of inflammatory response, and so on, but all fail to give a full explanation. With the development of neuroimaging technology, CP/CPPS patients are found with changes in the structure and function of the brain, and a large number of studies have confirmed the effect of acupuncture in improving the cerebral function and structure of the patients with chronic pain symptoms. This review outlines the advances in the studies of acupuncture therapy for CP/CPPS and its underlying central neural mechanisms, paving the theoretical ground for a deeper insight into the central neural mechanisms of and an optimized protocol for acupuncture treatment of CP/CPPS-related pain symptoms.