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Barbara Reed, MD
University of Michigan
Characterization of Pain Processing in Vulvodynia
Abstract: Vulvodynia is a chronic pain disorder, consisting of vulvar pain (burning, stabbing,
irritation) for three months or longer, and lack of an infectious or dermatologic diagnosis
consistent with the pain. The clinical characteristics of vulvodynia, and response to
pharmacological therapy, are consistent with those of neuropathic pain. However, previous data
from our group indicate increased sensitivity to pressure not only at the vulva, but also in the
periphery (thumb, deltoid, and shin), suggesting that central mechanisms may be playing a role in
women with vulvodynia. Further clarification of central and peripheral pain processing in women
with and without vulvodynia has the potential to dramatically increase our understanding of this
disorder, and will direct further study of pathophysiologic mechanisms and treatment options in
vulvodynia.
The specific aims of this study are: 1) to assess multi-modal sensory profiles at the vulva and in
the periphery of 100 women with vulvodynia and 50 women without vulvar pain, and to use
principal component and cluster analyses to identify novel subgroupings within the groups, and,
2) to further identify underlying mechanisms of vulvar pain in the established subgroupings by
identifying, via fMRI, the qualitative and quantitative differences in location and character of
supraspinal activity evoked by non-painful and painful sensory provocation at both vulvar and
peripheral sites. We expect to find significant differences among the validated groups, and to
then be able to use the known functional role of specific activated neural structures in the central
nervous system to further refine hypotheses about the mechanisms that initiate and maintain
painful vulvar disorders.
Information from this research is anticipated to further define vulvodynia and its variants, to define
subgroups based on underlying mechanisms, and to further our understanding of the
pathophysiology of women with this disorder.
back to NIH Funding
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