Larissa Rodriguez, MD, professor of urology and obstetrics and gynecology at the Keck School of Medicine of USC, and Jason Kutch, PhD, associate professor at the USC Division of Biokinesiology and Physical Therapy, have been awarded a $1.8 million grant from the National Institute of Diabetes and Digestive and Kidney Diseases. The grant is to support their continuing research on how a certain area of the brain might be responsible for interstitial cystitis/bladder pain syndrome (IC/BPS), a common and debilitating chronic condition affecting women.

“Interstitial cystitis is a chronic pain condition that severely affects the lives of women who suffer from the condition,” Rodriguez said. “The pain and urinary symptoms can be so severe that it can affect a patient’s ability to work, affect what they can and cannot do on a daily basis, what they can eat and their personal relationships. Unfortunately, there are few effective treatments and no cure, and many patients suffer in silence from daily symptoms.”

In their previous study, the research team compared the brain function of women with IC/BPS to that of women without the condition, discovering that women with IC/BPS have altered resting activity in a part of their brain shown to control pelvic floor muscle activity. 

In this new study, the researchers aim to determine if it is possible to reduce pain by improving brain and pelvic muscle activity, using non-invasive repetitive transcranial magnetic stimulation (TMS).

“TMS has become an important treatment approach in patients with depression and is even able to produce sustained remission in some patients. But TMS has not been as extensively studied in patients with chronic pain,” Kutch said. “We hope that this study can tell us if TMS can be tailored to reduce pain in patients with IC/BPS, so that it can help improve the lives of patients with this challenging condition.”

Preparing for the study

The researchers will recruit 75 women with IC/BPS, randomly dividing the women into three groups — one will receive high-frequency TMS, the second will receive low-frequency TMS, and the third will serve as the control group.

The researchers have three aims for this study:

• Reduce pain.
• Improve resting brain activity and resting pelvic-floor muscle electromyographic activity in women with IC/BPS.
• Link pain reductions to improvements in resting brain and pelvic floor activity to develop a detailed mathematical model of IC/BPS symptoms.

Research participants will undergo five consecutive days of TMS, with researchers comparing both short-term outcome measures as well as longer-term outcome measures (three weeks after the cessation of the stimulation).

“This new approach and therapy have great potential to positively affect the lives of women who suffer from this condition” Rodriguez said.

— John Hobbs